The medicare annual wellness visit: an opportunity to improve geriatric knowledge among internal medicine resident physicians

ABSTRACT

The Medicare Annual Wellness Visit (AWV) screens for risk factors of functional decline in older adults. However, the extent to which internal medicine resident physicians (“residents”) perform the AWV and feel confident in addressing its clinical topics has not been formally assessed. The number of AWVs completed by 47 residents and 15 general internists in a primary care clinic were calculated for June 2020 through May 2021. In June 2021, the residents were surveyed about their knowledge, skills, and confidence regarding the AWV. Residents averaged four completed AWVs, whereas general internists averaged 54 completed AWVs. 85% of residents responded to the survey; 67% of these resident respondents felt somewhat confident or confident that they understood the purpose of the AWV, and 53% felt similarly confident explaining the AWV to patients. Residents felt somewhat confident or confident treating depression/anxiety (95%), substance use (90%), falls (72%), and completing an advance directive (72%). The topics fewer residents felt somewhat confident or confident addressing were fecal incontinence (50%), IADLs (45%), and physical/emotional/sexual abuse (45%). By better understanding topics where residents are least confident, we identify opportunities for curriculum development in geriatric care and potentially increase the utility of the AWV as a screening tool.

KEYWORDS:

• Medicare annual wellness visit
• internal medicine curriculum
• primary care
• geriatric assessment

Acknowledgements

Dr Hurwitz received funding for this work through a Johns Hopkins PRISM grant. Drs. Colburn and Robertson were funded by the Geriatrics Workforce Enhancement Program (GWEP) through the Health Resources & Services Administration. Dr Colburn also receives funding through the Center for Innovative Medicine at Johns Hopkins University, and Dr Robertson is also funded through a grant through the National Institutes of Health T32 AG066576 and by The Secunda Family Scholars.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The work was supported by the Health Resources and Services Administration [Geriatrics Workforce Enhancement Program]; National Institutes of Health [T32 AG066576]; School of Medicine, Johns Hopkins University [Center for Innovative Medicine PRISM grant].