AFP DEPARTMENT COLLECTION

Editorials: Controversies in Family Medicine

This is a series of editorials presenting different views on current clinical issues in family medicine. Each editorial includes a link to another editorial with the opposing view.

Oct 1, 2020 Issue
Would Medicare for All Be the Most Beneficial Health Care System for Family Physicians and Patients? Yes: Improved Medicare for All Would Rescue an American Health Care System in Crisis
We must use the lessons of the coronavirus disease 2019 (COVID-19) pandemic to better prepare for the next one and address the shortcomings in our health care system.


Oct 1, 2020 Issue
Would Medicare for All Be the Most Beneficial Health Care System for Family Physicians and Patients? No: Medicare for All Would Cause Chaos and Fail to Control Health Care Costs
Expansion of Medicare or private insurance would not address the deeper problems in our health care system.


Aug 1, 2019 Issue
Should Adults with Prediabetes Be Prescribed Metformin to Prevent Diabetes Mellitus? No: Evidence Does Not Show Improvements in Patient-Oriented Outcomes
Discussing with patients the pros and cons of medications for borderline glucose values could distract us from more important topics such as lifestyle changes, smoking cessation, and blood pressure control. Time is the most valuable resource in a physician-patient partnership, and there are better ways to spend it.


Aug 1, 2019 Issue
Should Adults with Prediabetes Be Prescribed Metformin to Prevent Diabetes Mellitus? Yes: High-Quality Evidence Supports Metformin Use in Persons at High Risk
High-quality evidence supports metformin use for diabetes prevention among younger or more obese individuals or for women with a history of gestational diabetes. Clinicians should consider prescribing metformin, in addition to intensive lifestyle interventions, in accordance with patients' values and preferences.


Dec 15, 2017 Issue
Is "Precision Medicine" Ready to Use in Primary Care Practice? No: It Is Barely Ready for Testing
Precision medicine is ultimately only a tool, and just as it might be used to facilitate better outcomes, if adopted prematurely, it may paradoxically increase inappropriate care. Therefore, primary care physicians must wait for carefully conducted randomized studies to demonstrate benefits before embracing it.


Dec 15, 2017 Issue
Is "Precision Medicine" Ready to Use in Primary Care Practice? Yes: It Offers Patients More Individualized Ways of Managing Their Health
The question that primary care physicians should be considering is not whether precision medicine is ready for “prime time” in their practices. Rather, they should be considering how they will adjust their practice patterns to the changing landscape of medicine to maximize patient benefit while minimizing potential harms, including costs.


May 15, 2017 Issue
Should Screening Techniques for Colorectal Cancer All Have an 'A' Recommendation? No: When It Comes to Colorectal Cancer Screening, Test Choice Matters
The AAFP will continue to evaluate different screening tests as more research becomes available, but currently can endorse only those options that have the strongest evidence that benefits exceed harms.


May 15, 2017 Issue
Should Screening Techniques for Colorectal Cancer All Have an 'A' Recommendation? Yes: All Conventional Screening Techniques Should Have an 'A' Recommendation
We need to emphasize the message that regardless of which test is used, patients should get screened for colorectal cancer.


Jan 1, 2016 Issue
Should Family Physicians Routinely Screen Patients for Hepatitis C? No: One-time Screening Still Has Too Many Unanswered Questions
Given current scientific uncertainties, limited resources, and evolving guidelines, a reasonable middle ground would be to focus HCV testing and therapy on patients who are most likely to have long-term complications from the infection.


Jan 1, 2016 Issue
Should Family Physicians Routinely Screen Patients for Hepatitis C? Yes: Screening Makes Sense for High-Risk Adults
For patients to receive appropriate care for their chronic infection and receive curative treatment, they must first know they are infected, and it all begins with screening.


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