Physician Education Research Articles

Resident Physician Education in the Human Trafficking Medical Safe Haven.

Human trafficking is a widespread public health problem across the United States. In recognition of the incredible need among victims and survivors of human trafficking for longitudinal, trauma-informed care, the Medical Safe Haven (MSH) was developed in 2016 through the Dignity Health Family Medicine Residency Program in Sacramento, California, and subsequently expanded to 2 other Dignity Health residency program sites. The MSH program included 3 sessions of trafficking-specific curriculum for resident physicians to prepare them to provide care for MSH patients. The current study aimed to evaluate resident physician learner confidence after participating in the MSH curriculum along with perceptions of the MSH program as a whole upon their graduation. The study was a retrospective, preassessment/postassessment design. Resident physicians completed surveys that assessed learner confidence after each of the 3 training sessions, utilizing Likert scale items. Third-year resident physicians also completed a survey that included scaled and open-ended questions. Paired t-tests were used to evaluate the data in addition to content analysis for the open-ended questions. There were significant increases in learner confidence after the training sessions on all items measured, including identifying and caring for victims and survivors of trafficking. Third-year residents responded that the MSH program helped them to more effectively communicate and care for victims and survivors and many planned to take the trauma-informed care model to their future practices. While generalizability of the study was limited due to the retrospective design, the MSH program was found to have a meaningful impact on the resident physicians who participated in the training.

Physician education on World Asthma Day aids in disease management during the COVID-19

Anxiety and depression can negatively affect the management of asthma. The study aimed to assess the psychosocial effects of asthma patients during COVID-19 and analyze potential risk factors and interventions.In June 2022, the “Questionnaire Star” electronic questionnaire system was used to collect data. A total of 98 asthma patients from the affiliated hospital of the medical school of Ningbo University were invited to complete the questionnaires. According to our study, the prevalence of symptoms of anxiety and depression in the asthma patients in the institution was 91.8 and 77.6%, respectively. Patients who had an asthma exacerbation in the previous two months were more likely to have anxiety symptoms (OR = 0.142 95%CI 0.025–0.820), while patients who did not participate in asthma day activities were more likely to have anxiety symptoms than those who did (OR = 0.130 95%CI 0.022–0.762).This study found that routine disease educational lectures on asthma day can successfully alleviate asthma sufferers' anxiety and depression.

Foot Drop: The Importance of Imaging as Part of the Peripheral Nerve Evaluation

Dr. Smith is Assistant Professor of Neurosurgery, Duke University Medical Center, Durham, North Carolina; Dr. Jack is Associate Staff, Neurological Surgery, Cleveland Clinic, Cleveland, Ohio; and Dr. Spinner is Chair of Neurosurgery, Department of Neurologic Surgery, Burton M Onofrio MD Professor of Neurosurgery, and Professor of Orthopedics and Anatomy, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, E-mail: [email protected]. All authors, faculty, and staff have no relevant financial relationships with any ineligible organizations regarding this educational activity. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Category: Peripheral Nerve Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation on the enclosed form, answering at least 70% of the quiz questions correctly. This activity expires on December 29, 2024.

Methodology of the physicians education on the studying cycles of the Department of Combustiology and Plastic Surgery in modern environment

Methodology of the physicians education on the studying cycles of the Department of Combustiology and Plastic Surgery in modern environment

Quality Improvement Initiative to Improve Timing of Enteral Feeds in Pediatric Acute Pancreatitis.

Acute pancreatitis (AP) represents a significant disease burden in the pediatric population. The management of AP includes fluid resuscitation, pain management, and early enteral feeds. Contrary to old dogma, early enteral feeding has been shown to improve outcomes and reduce hospital length of stay (LOS), yet uptake of this approach has not been standardized. Our aim was to standardize the management of AP, increasing the percentage of patients receiving early enteral nutrition from 40% to 65% within 12 months. Between January 2013 and September 2021, we conducted a quality improvement initiative among patients hospitalized with AP. Interventions included the development of a clinical care pathway, integration of an AP order set, and physician education. Our primary outcome was the percentage of patients receiving enteral nutrition within 48 hours of admission, and our secondary outcome was hospital LOS. Balancing measures included hospital readmission rates. A total of 652 patients were admitted for AP during the project, of which 322 (49%) were included after pathway implementation. Before pathway development, the percentage of patients receiving early enteral nutrition was 40%, which increased significantly to 84% after our interventions. This improvement remained stable. Median LOS decreased significantly from 5.5 to 4 days during this timeframe. Our balancing measure of readmission rates did not change during the project period. Through multiple interventions, including the implementation of an AP clinical pathway, we significantly increased the proportion of patients receiving early enteral nutrition and decreased hospital LOS without increasing hospital readmission rates.

Benefits and limitations of hypo/hyperglycemic alarms associated with continuous glucose monitoring in individuals with diabetes

Continuous Glucose Monitoring (CGM) has improved the diabetes follow up. The use of CGM can be expected to reduce the long-term complications of diabetes. To achieve this, education of physicians and diabetic individuals is essential. The latest CGMs have alarms to improve glycemic control by avoiding hypoglycemia and hyperglycemia, hence the importance of proper setting of these alarms. Although useful to signal these events, we have noted that these alarms do not necessarily meet with unanimity in consultations… Are alarms considered a comfort or a possible disturbance ?

Provider ankle brachial index and wound classification teaching as part of a comprehensive limb preservation outreach program

ObjectiveUtilization of evidence-based specialty guidelines is low in primary care settings. Early use of ankle-brachial index (ABI) testing and a validated wound classification system allows prompt referral of patients for specialty care. We implemented a program to teach providers ABI testing and the use of the Wound, Ischemia, and foot Infection (WIfI) classification tool. Here, we report program outcomes and provider perceptions. MethodsPhysicians and non-physicians from wound care centers, nursing and physician education programs, primary care offices, and federally qualified health centers were invited to participate in the educational program teaching ABI testing and the use of the WIfI tool. Pretest and posttest responses and intention to use content in the future were assessed with descriptive statistics. ResultsA total of 101 subjects completed the ABI module, and 84 indicated their occupation (59 physicians, 25 non-physicians). Seventy-nine subjects completed the WIfI module, and 89% indicated their occupation (50 physicians, 20 non-physicians). Physicians had lower pre-test knowledge scores for the ABI module than non-physicians (mean scores of 7.9 and 8.2, respectively). Both groups had improved knowledge scores on the post-test (physicians, 13.4; non-physicians, 13.8; P < .001). Non-physicians in practice longer than 10 years at wound care centers had the lowest baseline knowledge scores, whereas physicians in practice for over 10 years had the highest. In the ABI module, the largest knowledge gap included accurately calculating the ABI, followed by the correct use of the Doppler, and management of incompressible vessels. For the WIfI module, providers struggled to accurately score patients based on wound classification. The greatest barriers to the implementation of ABI testing were the availability of trained personnel, followed by limited time for testing. Barriers to the use of the WIfI tool for physicians included lack of time and national guideline support. For non-physicians, the most notable barrier was a lack of training. ConclusionsProvider understanding of ABI and WIfI tools are limited in wound care centers, primary care offices, and federally qualified health centers. Further barriers include a lack of training in the use of tools, limited potential for point-of-care testing reimbursement, and insufficient dissemination of WIfI guidelines. Such barriers discourage widespread adoption and result in delayed diagnosis of arterial insufficiency.

Recruitment in Acute Stroke Trials: Challenges and Potential Solutions.

Randomized clinical trials of acute stroke have led to major advances in acute stroke therapy over the past decade. Despite these successes, recruitment in acute trials is often difficult. We outline challenges in recruitment for acute stroke trials and present potential solutions, which can increase the speed and decrease the cost of identifying new treatments for acute stroke. One of the largest opportunities to increase the speed of enrollment and make trials more generalizable is expansion of inclusion criteria whose impact on expected recruitment can be assessed by epidemiologic and registry databases. Another barrier to recruitment besides the number of eligible patients is availability of study investigators limited to business hours, which may be helped by financial support for after-hours call. The wider use of telemedicine has accelerated quicker stroke treatment at many hospitals and has the potential to accelerate research enrollment but requires training of clinical investigators who are often inexperienced with this approach. Other potential solutions to enhance recruitment include rapid prehospital notification of clinical investigators of potential patients, use of mobile stroke units, advances in the process of emergency informed consent, storage of study medication in the emergency department, simplification of study treatments and data collection, education of physicians to improve equipoise and enthusiasm for randomization of patients within a trial, and clear recruitment plans, and even potentially coenrollment, when there are competing trials at sites. Without successful recruitment, scientific advances and clinical benefit for acute stroke patients will lag.

Care of patients with inborn errors of immunity in thirty J Project countries between 2004 and 2021.

The J Project (JP) physician education and clinical research collaboration program was started in 2004 and includes by now 32 countries mostly in Eastern and Central Europe (ECE). Until the end of 2021, 344 inborn errors of immunity (IEI)-focused meetings were organized by the JP to raise awareness and facilitate the diagnosis and treatment of patients with IEI. In this study, meeting profiles and major diagnostic and treatment parameters were studied. JP center leaders reported patients' data from 30 countries representing a total population of 506 567 565. Two countries reported patients from JP centers (Konya, Turkey and Cairo University, Egypt). Diagnostic criteria were based on the 2020 update of classification by the IUIS Expert Committee on IEI. The number of JP meetings increased from 6 per year in 2004 and 2005 to 44 and 63 in 2020 and 2021, respectively. The cumulative number of meetings per country varied from 1 to 59 in various countries reflecting partly but not entirely the population of the respective countries. Altogether, 24,879 patients were reported giving an average prevalence of 4.9. Most of the patients had predominantly antibody deficiency (46,32%) followed by patients with combined immunodeficiencies (14.3%). The percentages of patients with bone marrow failure and phenocopies of IEI were less than 1 each. The number of patients was remarkably higher that those reported to the ESID Registry in 13 countries. Immunoglobulin (IgG) substitution was provided to 7,572 patients (5,693 intravenously) and 1,480 patients received hematopoietic stem cell therapy (HSCT). Searching for basic diagnostic parameters revealed the availability of immunochemistry and flow cytometry in 27 and 28 countries, respectively, and targeted gene sequencing and new generation sequencing was available in 21 and 18 countries. The number of IEI centers and experts in the field were 260 and 690, respectively. We found high correlation between the number of IEI centers and patients treated with intravenous IgG (IVIG) (correlation coefficient, cc, 0,916) and with those who were treated with HSCT (cc, 0,905). Similar correlation was found when the number of experts was compared with those treated with HSCT. However, the number of patients treated with subcutaneous Ig (SCIG) only slightly correlated with the number of experts (cc, 0,489) and no correlation was found between the number of centers and patients on SCIG (cc, 0,174). 1) this is the first study describing major diagnostic and treatment parameters of IEI care in countries of the JP; 2) the data suggest that the JP had tremendous impact on the development of IEI care in ECE; 3) our data help to define major future targets of JP activity in various countries; 4) we suggest that the number of IEI centers and IEI experts closely correlate to the most important treatment parameters; 5) we propose that specialist education among medical professionals plays pivotal role in increasing levels of diagnostics and adequate care of this vulnerable and still highly neglected patient population; 6) this study also provides the basis for further analysis of more specific aspects of IEI care including genetic diagnostics, disease specific prevalence, newborn screening and professional collaboration in JP countries.

Virtual reality technology in physician education: focus on emergency medical care

Virtual reality technology has been developing rapidly over the past two decades and is becoming available in various areas of healthcare — in surgery, neurology, rehabilitation, and education. The need for virtual reality technology is also manifested in the development of algorithms for emergency medical care by primary care physicians. Currently, 6 interactive case problems have been developed for the most common emergency conditions, requiring, among other things, resuscitation. The concept of teaching using virtual reality technology has become the basis for the development of an additional professional advanced training program for general practitioners "Development of an algorithm for providing emergency medical care for sudden acute diseases and conditions". A unique feature of the program is the ability to practice the emergency medical care algorithm using virtual reality technology, as well as practice skills using a simulation manikin and an automatic external defibrillator.

945. Development of Antimicrobial Stewardship Programs in Central and South America

Abstract Background There is a need to assess current development of hospital Antimicrobial Stewardship Programs (ASPs) in Latin America. Methods Cross-sectional evaluation of ASPs using a standardized and previously validated self-assessment tool derived from the Centers for Disease Control and Prevention Core Elements of Antibiotic Stewardship (AS). The assessment was deployed to 40 hospitals in Panama, Guatemala, Ecuador, Colombia, and Argentina in 3/2022 through a regional research network. The assessment included 94 questions, with each question including a graded response (meets criteria, partially meets criteria, does not meet criteria, and in some, not applicable). Results 22 public and 16 private hospitals completed the assessment (95% response rate), 10% and 25% of which were small hospitals (&amp;lt; 110 beds), respectively. 82% were academic, and all have an Infection Prevention and Control program/committee. &amp;gt;70% of ASPs have a physician and pharmacist involved, although 65% reported no salary support for AS activities. Only 13% and 29% of AS pharmacists and physicians, respectively, met recommended full-time equivalent/bed ratios; and 76% lacked information and technology (IT) support. 50% indicated the AS committee did not meet regularly, and another 50% reported not including non-AS physicians in the committee. Most hospitals have implemented prior-authorization and post-prescription review and feedback, with much fewer reporting a process to alert of duplicate therapy and use of auto-stops. 89% reported regular access to new antibiotics. While most hospitals monitor antibiotic consumption, few evaluate trends and/or appropriateness of use. Treatment guidelines for most common infections were missing in up to 50% of hospitals, especially in public hospitals. Most respondents indicated their hospitals promote teamwork, and in the vast majority, recommendations from AS are valued. Stratification of results by private and public hospitals in Table. Table:Results of a self-assessment of antimicrobial stewardship activities at the facility level in 38 hospitals in Latin America. Conclusion We found several opportunities for improvement, which differed between private and public hospitals. Common barriers to both settings include access to IT support; better pharmacist and physician resource allocation, education, and monitoring of process and outcomes measures. Disclosures Sara E. Cosgrove, MD, Basilea: Member of Infection Adjudication Committee.

Impact of COVID-19 pandemic on the management of patients with RA: a survey of rheumatologists in six European countries.

We aimed to describe, from the perspective of rheumatologists in Europe, how the coronavirus disease 2019 (COVID-19) pandemic has impacted their management of people with RA and the continuing medical education of physicians. Rheumatologists participating in the Adelphi RA Disease Specific ProgrammeTM in six European countries were contacted in August and September 2020 for a telephone survey. Rheumatologists were asked seven attitudinal questions on changes to patient management, prescription behaviour and continuing education owing to COVID-19. Results were summarized with descriptive statistics. The telephone survey was completed by 284 rheumatologists. The most commonly reported changes to patient management were increased utilization of video/telephone consultations (66.5% of respondents), fewer visits (58.5%) and limiting physical contact (58.1%). Furthermore, 67.9% of rheumatologists who indicated that prescribing behaviour had changed switched their patients to self-administered medication, and 60.7% reported not starting patients on targeted synthetic DMARDs, biologic originator DMARDs or biosimilar DMARDs. In total, 57.6% of rheumatologists believed that changes in management would persist. Rheumatologists reported that 38.0% of patients expressed concerns about how COVID-19 would impact treatment, including access to treatment and the risk of infection. The biggest impact on rheumatologist education was a switch to online training and conferences. All countries saw changes in patient management and prescribing behaviour, including the rapid uptake of telemedicine. It is important that the international rheumatology community learns from these experiences to prepare better for future pandemics and to address ongoing rheumatologist shortages.

Themes of medical profession and professional socialization in medical sociology textbooks

Introduction: The present study examines the information on the medical profession and how the changes occurring in the medical practice, the social role and the evaluation of the physician are reflected in the English and Hungarian language medical sociology textbooks used in Hungary. Method: We analyzed chapters of Hungarian language medical sociology textbooks of thelast 25 years that discuss medical profession and student choices, and textbooks used in English language courses of Semmelweis University. Results: The corpus of the Hungarian textbooks (history of medical profession, medical role models, models of doctor-patient relationships, medical socialization) stayed relatively unchanged. While preserving the myth of the medical profession, there are criticisms towards the role and relationship models. The theme of the medical education gradually disappears from theEnglish language textbooks. The social positions of the medical profession and health care are discussed in a broader context, focusing on the health care system and health care provision, incorporating the allied professions, and taking aspects of patients/consumers into greater consideration. Summary: Both textbook types reflect on the changes in the social position of the medical profession. However, the English literature approaches the modernization processes from the angles of the health care system and health care provision, resulting in the diminishing importance of the topic of medical profession while the Hungarian literature focuses on the profession and professional education of physicians.

Understanding motivations behind medical student involvement in COVID-19 pandemic relief efforts

BackgroundAlthough students were removed from patient-facing settings at the beginning of the COVID-19 pandemic due to concerns of burdening teaching physicians and depleting personal protective equipment, some leaders suggest students can be effectively utilized when personnel resources may be scarce. There have been narrative discussions surrounding medical student involvement, but no studies exploring the attitudes of these students. The authors aim to quantify the degree to which factors influenced a medical student’s decision to or to not volunteer during the pandemic and to characterize medical students’ attitudes towards medical professionals’ duty to serve in a pandemic.MethodsThe authors developed and tested a secure web-based survey before distribution to students at 23 different US allopathic medical schools that did not graduate medical students early to aid in pandemic efforts between April and June 2020. Of the 599 students who completed the survey, 65.5% self-identified as female and were on average 25.94 years old (SD = 2.5). Multiple comparisons were made based on volunteer status. Ordinal scale questions were compared with the Mann Whitney U test, and the Chi-Squared test was used for categorical variables using R version 3.62.Results67.6% of students volunteered in pandemic relief activities and a majority of those students volunteered in non-patient-facing roles. Community service, new skills, and time commitment were top 3 influencing factors for students who volunteered, while risk to other, time commitment, and risk to self were top 3 influencing factors for students who chose not to volunteer. Compared to other specialties, students interested in primary care specialties agreed to a greater degree that physicians have a duty to serve in pandemic relief efforts.ConclusionsMedical students who volunteered cited self-serving factors and altruistic values as significant motivators. Students who did not volunteer were significantly more concerned with risks of COVID-19 exposure. However, medical students in general agreed that students should be allowed to volunteer in COVID-19 related relief efforts. As large areas of the United States continue to experience increases in COVID-19 cases, institutions should involve medical students in balancing the level of acceptable risk with the educational benefits.

Physician Awareness of Immune-Related Adverse Events of Immune Checkpoint Inhibitors.

Immune checkpoint inhibitors (ICIs) have been proven to be very effective in the treatment of multiple cancers. They have a unique side-effect profile distinct from conventional chemotherapy that can manifest as immune-related adverse events (irAEs). With expanding ICI use, clinicians will increasingly encounter irAEs, and thus adequate physician knowledge on their recognition and management is crucial. To assess physician knowledge of irAEs due to ICIs, an online survey was administered to resident physicians in internal medicine (IM), emergency medicine, and family medicine (FM), as well as to faculty physicians in IM and FM. We sent the survey to 413 physicians and received responses from 155 (38%), of which 110 were residents and 45 were faculty. Pembrolizumab was identified as an ICI by 79% of physicians, nivolumab by 64%, and ipilimumab by 55%. Twenty-five percent incorrectly thought infliximab and adalimumab were ICIs. Most physicians (93%) were able to identify the gastrointestinal tract as an irAE site, whereas only 57% and 67% were able to identify cardiovascular and renal systems as irAE sites, respectively. A total of 59% believed steroids negatively affect efficacy of ICIs and should be used with caution to treat irAEs, 65% incorrectly thought endocrinopathies due to irAEs are usually reversible, and 45% of FM residents considered antibiotics as the mainstay of treatment in ICI-mediated colitis. On a self-rated scale from 0 to 100, the median comfort level for all physicians in recognizing irAEs was 15 and for treatment of irAEs was 10. Significant knowledge gaps exist among residents and faculty physicians across multiple specialties regarding the recognition and treatment of irAEs due to ICIs. Given that these physicians are usually the first point of contact with patients, physician education on identification and treatment of irAEs is needed. Early detection of these toxicities is critical for their resolution.

Medical student perceptions and attitudes related to interprofessional collaboration at a student-run free clinic

Many medical universities have student-run free clinics that enable trainees to obtain hands-on clinical experience with underserved populations. This study takes place at one such clinic based at a multidisciplinary health sciences institution in the midwestern U.S. As part of a federally funded program, the research team conducted a survey of the clinic's student volunteers over a 6-month period. Students were queried about their experiences working in the clinic, including perceptions of collaboration with other student volunteers, satisfaction with shared decision-making, confidence with delivering care in various formats (including telehealth), and experiences working on interprofessional teams. Results indicated that overall, students reported a high degree of collaboration within the clinic and expressed confidence working in teams. Moreover, more experienced students reported greater satisfaction with the collaboration among team members, as well as more confidence with working as a member of a team, as compared to first-year students. Students who volunteered at the clinic more frequently also reported greater confidence working as part of a telemedicine team, as compared to students who spent fewer days staffing the clinic. This research can inform institutional efforts to improve the quality of interprofessional education and experiential learning for future physicians and other healthcare professionals.

The MetaPharmacy: What Happens When Big Pharma Goes Virtual?

The MetaPharmacy: What Happens When Big Pharma Goes Virtual?

Benefits and Risks of Low-Dose, Add-On Prednisolone in Older Patients With Rheumatoid Arthritis

Ms. Hoffmeister is a freelance medical writer in Camp Hill, Pennsylvania. To earn CME credit, you must read the CME articles and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This continuing medical enduring material activity expires November 30, 2024. All authors, faculty, and staff have no relevant financial relationships with any ineligible organizations regarding this educational activity. Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Lippincott's Bone and Joint Newsletter is an independent publication solely owned and published by Wolters Kluwer and has no affiliation with the Journal of Bone & Joint Surgery.

Does Conditioned Pain Modulation Predict Pain Outcomes?

Ms. Ward is a registered nurse at University of Maryland Medical Center, Baltimore, Maryland, and Dr. Starkweather is Chamings Professor & Assistant Dean for Research Development, Department of Biobehavioral Nursing Science, University of Florida College of Nursing, PO Box 100197, Gainesville, FL 32610; E-mail: [email protected]. All authors, faculty, and staff have no relevant financial relationship with any ineligible organizations regarding this educational activity. CME Accreditation Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. This CME activity expires on November 30, 2024. NCPD Accreditation Lippincott Professional Development is accredited as a provider of nursing continuing professional development (NCPD) by the American Nurses Credentialing Center's Commission on Accreditation. Lippincott Professional Development will award 2.0 contact hours for this NCPD activity. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states. Instructions for earning ANCC contact hours are included on page 11 of the newsletter. This NCPD activity expires on December 5, 2025.

The diagnostic experience of women with fragile X-associated primary ovarian insufficiency (FXPOI).

The fragile X premutation occurs when there are 55-200 CGG repeats in the 5' UTR of the FMR1 gene. An estimated 1 in 148 women carry a premutation, with 20-30% of these individuals at risk for fragile X-associated primary ovarian insufficiency (FXPOI). Diagnostic experiences of FXPOI have not previously been included in the literature, limiting insight on experiences surrounding the diagnosis. This study identifies barriers and facilitators to receiving a FXPOI diagnosis and follow-up care, which can inform care and possibly improve quality of life. We conducted qualitative interviews with 24 women with FXPOI exploring how FMR1 screening, physician education, and supportive care impacted their experience. Three subgroups were compared: women diagnosed through family history who have biological children, women diagnosed through family history who do not have biological children, and women diagnosed through symptoms of POI. Themes from interviews included hopes for broader clinician awareness of FXPOI, clear guidelines for clinical treatment, and proper fertility workups to expand reproductive options prior to POI onset. Participants also spoke of difficulty finding centralized sources of care. Our results indicate a lack of optimal care of women with a premutation particularly with respect to FMR1 screening for molecular diagnosis, short- and long-term centralized treatment, and clinical and emotional support. The creation of a "FXPOI health navigator" could serve as a centralized resource for the premutation patient population, assisting in connection to optimal treatment and appropriate referrals, including genetic counseling, mental health resources, advocacy organizations, and better-informed physicians.