Reflecting on the Breadth of Family Medicine
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Am Fam Physician. 2006 Apr 1;73(7):1133.
Last week, I witnessed firsthand the versatility of family physicians. On a visit to my family physician, I noticed the waiting room contained men, women, and children whose ages spanned at least eight decades. Then, during my physical, my physician addressed a variety of issues, such as cholesterol, a thyroid nodule, a skin rash, a painful muscle spasm, and arthritis. I realized then how many appointments with different specialists I would have had were it not for my family physician being so well versed in many areas of medicine.
My appointment took some time, but my physician seemed totally focused on me and did not rush. When I left, I noticed the name of the practice on the sign—it includes the word “care.” I became acutely aware of how a family physician really cares for a variety of patients.
The content of a typical issue of AFP testifies to the broad scope of family medicine. For example, this issue presents articles on a wide variety of topics, some common and some less prevalent. These include the silent but deadly killer—abdominal aortic aneurysm—as well as dementia, pleural effusion, and vulvodynia. We also have articles about family physicians as emergency physicians in rural areas, prolonged mechanical ventilation, and medications for osteoarthritis.
Continuing Medical Education
The AFP Clinical Quiz (page 1149) offers an opportunity for readers to earn continuing medical education (CME) credits. This issue is acceptable for up to 5.5 Prescribed credits, of which 2.0 credits qualify for evidence-based (EB) CME. The Academy doubles EB CME credit to reflect two-for-one credit for the EB CME portion of the content. CME published by the Academy qualifies for the American Medical Association (AMA) Physician’s Recognition Award (PRA) Category 1 Credit. However, the AMA does not double credits for EB CME, so the total AMA/PRA credits differ from the total Academy credits.
Clinical Review Articles
Abdominal aortic aneurysm (AAA) is difficult to detect, but this relatively common condition kills at least 15,000 people each year. The article by Gilbert Upchurch, M.D., and Timothy Schaub, M.D., (page 1198) will help you detect patients who are at risk for AAA, create a plan of care, and determine the best approach to repair.
Determining whether the effusion is a transudate or an exudate is the first step in evaluating patients with pleural effusion. The article by Jose Porcel, M.D., and Richard Light, M.D., (page 1211) outlines the diagnostic strategies for each.
The article by Doug Neef, M.D., and Anne D. Walling, M.B., Ch.B., (page 1223) explains dementia with Lewy bodies, an emerging condition that accounts for about one in five cases of dementia.
A thorough history to rule out infection and dermatologic abnormalities is required in the diagnosis of vulvodynia. The article by Barbara Reed. M.D., M.S.P.H., (page 1231) presents the diagnostic procedures and several treatment options.
Three of the review articles mentioned above include patient information handouts. Please note that patient information handouts are listed with the articles on the table of contents, and now also in a special section on the second page of the table of contents.
The Graham Center One-Pager (page 1163) addresses family physicians providing emergency department care in many rural facilities. The article presents data showing that many rural areas need family physicians, as well as combined professional efforts, to meet the emergency care needs of a rural population.
Two departments in this issue address the use of glucosamine for the treatment of osteoarthritis. The Cochrane for Clinicians review (page 1189) states that glucosamine is effective in reducing pain and improving the function of joints affected by osteoarthritis. FPIN’s Clinical Inquiries (page 1245) addresses the use of glucosamine and chondroitin to treat osteoarthritis.
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