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Revised Poverty Line Could Endanger Millions, AAFP Warns

The AAFP has urged the Trump administration to reconsider a proposed recalibration of the federal poverty line that could greatly reduce the number of patients able to qualify for Medicaid and other safety-net programs.

AAFP News : Advocacy and Government

https://www.aafp.org/news/government-medicine/20190702revpovertyline.html

Preventing Spontaneous Abortion with Progestin Therapy - Medicine by the Numbers - ...

Jul 1, 2019 - The use of progestin therapy in women with recurrent pregnancy loss appears to reduce the incidence of spontaneous abortion, preterm labor, and stillbirth, and increase the rate of live birth. However, due to issues with the studies the authors were hesitant to give progestin their full...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0701/od1.html

Polypharmacy: Evaluating Risks and Deprescribing - American Family Physician

Jul 1, 2019 - Polypharmacy, defined as regular use of at least five medications, is common in older adults and younger at-risk populations and increases the risk of adverse medical outcomes. There are several risk factors that can lead to polypharmacy. Patient-related factors include having multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p32.html

Pharmacologic Therapy for Heart Failure - FPIN's Help Desk Answers - American Family ...

Jul 1, 2019 - Compared with monotherapy, the combination of an ACE inhibitor and an ARB has not been shown to improve cardiovascular or overall mortality in patients with symptomatic heart failure. The combination is associated with an increased number of adverse drug effects.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0701/p49.html

Medication Management for Chronic Heart Failure with Preserved Ejection Fraction - ...

Jul 1, 2019 - Mineralocorticoid receptor antagonists reduce hospitalizations for patients with HFpEF. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have not been shown to change the morbidity or mortality in patients with HFpEF.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0701/p17.html

Study Compares USPSTF, Other Lung Cancer Screening Guidance

A research letter published June 4 in Annals of Internal Medicine discussed a study that analyzed how new risk thresholds could identify more current/former smokers eligible for lung cancer screening.

AAFP News : Patient Care

https://www.aafp.org/news/health-of-the-public/20190629lungcastudy.html

AAFP Backs Breastfeeding, Lactation for Medical Trainees

The AAFP has updated its policy supporting breastfeeding and lactation accommodations for medical trainees, which other medical organizations plan to use as model policy for their members.

AAFP News : Patient Care

https://www.aafp.org/news/health-of-the-public/20190626breastfeedpolicy.html

Obesity Education in Family Medicine Clerkships Falls Short

New research on obesity education in family medicine clerkships shows gaps that may leave future family physicians inadequately prepared to treat patients with this condition.

AAFP News : CME

https://www.aafp.org/news/education-professional-development/20190625obesityeduc.html

Do Residents' Skills Match Medicare Patients' Needs?

New research suggests that family medicine residents' training does not align with the most common procedures that Medicare patients need.

AAFP News : CME

https://www.aafp.org/news/education-professional-development/20190620proceduretraining.html

My Message to Students: Why Family Medicine Matters

Marking the sixth anniversary of his graduation from residency, Kurt Bravata, M.D., reflects on what he wishes every first-year medical student knew about family medicine.

AAFP News : Blogs

https://www.aafp.org/news/blogs/freshperspectives/entry/20190619fpwhyfm.html

AAFP Delegation Stands Up for Residency Teaching Faculty

AAFP delegates supported physicians-in-training during this year's AMA House of Delegates annual meeting as they sought to ensure that their instructors can devote adequate time to teaching duties.

AAFP News : CME

https://www.aafp.org/news/education-professional-development/20190619ama-educ.html

Diabetic Kidney Disease: Diagnosis, Treatment, and Prevention - American Family Physician

Jun 15, 2019 - Globally, approximately 20% of the 400 million individuals with diabetes mellitus have diabetic kidney disease (DKD). DKD is associated with higher cardiovascular and all-cause morbidity and mortality, so timely diagnosis and treatment are critical. Screening for early DKD is best done ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p751.html

Plantar Fasciitis - American Family Physician

Jun 15, 2019 - Plantar fasciitis is a common problem that one in 10 people will experience in their lifetime. Plantar fasciopathy is an appropriate descriptor because the condition is not inflammatory. Risk factors include limited ankle dorsiflexion, increased body mass index, and standing for ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p744.html

Depression Following Acute Coronary Syndrome Events: Screening and Treatment Guidelines...

Jun 15, 2019 - ...CRAIG W. ROBBINS, MD, MPH, FAAFP, Kaiser Permanente School of Medicine, Pasadena, California JAMES J. STEVERMER, MD, MSPH, FAAFP, University of Missouri Health Care, Columbia, Missouri ROBERT T. CHOW, MD, MBA, MACP, University of Maryland Medical Center Midtown Campus, Baltimore,...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0615/od2.html

Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in ...

Jun 15, 2019 - The USPSTF recommends screening for unhealthy alcohol use in primary care settings in adults 18 years or older, including pregnant women, and providing persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce unhealthy alcohol use.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/0615/od1.html

Community-Acquired Pneumonia: Determining Safe Treatment in the Outpatient Setting - ...

Jun 15, 2019 - When is it safe to treat a patient with community-acquired pneumonia a an outpatient?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0615/p768.html

Use of More Specific Terminology May Assist in Better Diagnosis of Abdominal Wall ...

Jun 15, 2019 - ...Based on this premise, the Family Medicine Education Consortium's Interventions to Minimize Preterm and Low Birthweight Infants through Continuous Quality Improvement Techniques Network (www.fmec.net/implicit) developed a proactive approach to interconception care. As a quality...

American Family Physician : Letter

https://www.aafp.org/afp/2019/0615/p731.html

Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in ...

Jun 15, 2019 - A 20-year-old male with a history of exercise-induced asthma presents to your office for his yearly physical. He is a student at the local university and is on the university fencing team. When asked about his classwork, he expresses that college is going okay but can be stressful ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0615/p771.html

H. pylori Screening Before Initiation of Long-term NSAIDs - FPIN's Clinical Inquiries -...

Jun 15, 2019 - Physicians should perform laboratory screening for and eradicate H. pylori before initiating long-term NSAID therapy in NSAID-naive patients to reduce the risk of peptic ulcer disease.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0615/p783.html

Ensuring Primary Care Access in States with an Aging Family Physician Workforce - ...

Jun 15, 2019 - In many states, at least 40% of family physicians are older than 55. Therefore, policymakers should support broad training models that produce enough primary care physicians to meet state population needs.

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2019/0615/p743.html

JAMA Research: Elderly Deaths From Falls Increase

Death rates from falls for older adults in the United States have significantly increased in the past 16 years, but an exercise program might help.

AAFP News : Patient Care

https://www.aafp.org/news/health-of-the-public/20190612elderlyfalls.html

60-Second Survey Gives Insight Into Unmet Social Needs

Researchers found that a brief survey administered to patients helped identify obstacles to maintaining good health.

AAFP News : Practice and Career

https://www.aafp.org/news/practice-professional-issues/20190612minutesurvey.html

Going the Extra Mile for Transgender Patients

When Izzy Lowell, M.D., M.B.A., realized how great the need was for transgender care in her region, she created a five-state practice to fill the void.

AAFP News : Family Doc Focus

https://www.aafp.org/news/family-doc-focus/20190610fdf-lowell.html

AMA Opioid Task Force Outlines Road Map to End Epidemic

The AMA Opioid Task Force, to which the AAFP belongs, released recommendations on May 30 that call on policymakers to eliminate barriers to treatment for opioid use disorder.

AAFP News : Patient Care

https://www.aafp.org/news/health-of-the-public/20190605amaopioidtf.html

Academy Lauds Bills Aimed at Curbing Teen Smoking, Vaping

The AAFP is voicing support for several recent bills addressing the U.S. epidemic of youth tobacco and nicotine use.

AAFP News : Advocacy and Government

https://www.aafp.org/news/government-medicine/20190605tobacco21.html

Study: Talking About Medication Costs Yields Rewards

Researchers found that a 60-minute training intervention with physician practices helped increase the frequency of cost-of-medication conversations with patients, which, in turn, enabled clinicians to identify those for whom cost was a specific barrier.

AAFP News : Practice and Career

https://www.aafp.org/news/practice-professional-issues/20190605costconversations.html

FP Reflects on Service on Front Lines of Family Medicine

During a 22-year stint in the Army, including more than a decade serving as a White House physician, Col. Kevin O'Connor, D.O., has found himself continually searching for ways to better serve his patients, whether it's in a classroom, at a hospital or in a war zone.

AAFP News : Family Doc Focus

https://www.aafp.org/news/family-doc-focus/20190603fdf-oconnor.html

Antibiotic Prophylaxis in Patients with COPD - Medicine by the Numbers - American ...

Jun 1, 2019 - This research fails to determine whether the modest potential benefits of antibiotic prophylaxis in patients with chronic obstructive pulmonary disease outweigh the risk of resistance. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0601/od1.html

Adolescent Substance Use and Misuse: Recognition and Management - American Family ...

Jun 1, 2019 - Adolescent use of illicit substances imposes an enormous burden on individuals, families, and communities. The types of illicit substances adolescents are using have changed drastically over the past decade with decreases in alcohol use (including binge alcohol use) offset by increases ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p689.html

Caregiver Care - American Family Physician

Jun 1, 2019 - Eighty percent of adults requiring long-term care currently live at home in the community, and unpaid family caregivers provide 90% of their care. Family caregivers serve as a critical extension of the U.S. health care system, and the demand for family caregivers is expected to increase...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p699.html

Coding & Documentation - May-Jun 2019 -- FPM

Jun 1, 2019 - Same-day return visit | Modifier for incident-to services | Inpatient care billing by teaching physician | Biopsy of the outer ear | Multiple X-rays

Family Practice Management : Coding & Documentation

https://www.aafp.org/fpm/2019/0500/p31.html

Anticoagulation for the Long-term Treatment of VTE in Patients with Cancer - Cochrane ...

Jun 1, 2019 - Low-molecular-weight heparin (LMWH), vitamin K antagonists, and direct oral anticoagulants, when used to prevent recurrent VTE, have a similar impact on all-cause mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0601/p676.html

Seven Habits for Reducing Work After Clinic -- FPM

Jun 1, 2019 - Imagine shutting your office door at the end of the day and not having any work that you need to take home. These shifts in practice can help you reclaim your time.

Family Practice Management : Articles

https://www.aafp.org/fpm/2019/0500/p10.html

Transitional Care Management: Practical Processes for Your Practice -- FPM

Jun 1, 2019 - Helping patients safely bridge the gap from acute care to ambulatory care is good for patients and practices too.

Family Practice Management : Articles

https://www.aafp.org/fpm/2019/0500/p27.html

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

Practice Pearls - May-Jun 2019 -- FPM

Jun 1, 2019 - Create annual visit plans for your patients | Use your EHR to close care gaps | Use passwords to practice mindfulness

Family Practice Management : Practice Pearls

https://www.aafp.org/fpm/2019/0500/p32.html

Sharp Rise Seen in Teen Self-Poisoning Suicide Attempts

Rates of attempted suicide by self-poisoning among U.S. adolescents and young adults have more than doubled in the past decade. Among girls and young women, rates nearly tripled during that period.

AAFP News : Patient Care

https://www.aafp.org/news/health-of-the-public/20190529self-poison.html

Research Highlights the Enigma of Primary Care Spending

A recent analysis of overall health care spending on Medicare beneficiaries found that spending on primary care accounted for just a small percentage of total fee-for-service expenditures.

AAFP News : Practice and Career

https://www.aafp.org/news/practice-professional-issues/20190529pcspendstudy.html

Lawmakers Need Guidance to Fix U.S. 'Wealth Care' Culture

The Family Medicine Advocacy Summit opened with detailed advice on how FPs can use stories and data to win greater support from legislators for primary care.

AAFP News : Advocacy and Government

https://www.aafp.org/news/government-medicine/20190528fmas-caseforpc.html

FP Delivers Best of Family Medicine Throughout Long Career

During his 65-year career as a family physician, Alexander D. "A.D." Brickler II, M.D., has cared for a remarkable number of Tallahassee families and delivered more than 30,000 babies. The recently retired 90-year-old also helped deliver racially integrated health care to his Florida city.

AAFP News : Family Doc Focus

https://www.aafp.org/news/family-doc-focus/20190520fdf-brickler.html

Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation - American...

May 15, 2019 - Many people with depression or anxiety turn to nonpharmacologic and nonconventional interventions, including exercise, yoga, meditation, tai chi, or qi gong. Meta-analyses and systematic reviews have shown that these interventions can improve symptoms of depression and anxiety ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p620.html

Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults - ...

May 15, 2019 - A.F., a 32-year-old woman, presents for a health maintenance visit. It has been more than a year since she was last seen. She has no significant medical history and has never used tobacco, alcohol, or any other substances.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0515/p649.html

Risk of GI Bleeding Highest with Rivaroxaban, Lower with Apixaban, and Lowest with PPI ...

May 15, 2019 - Among patients using oral anticoagulants alone, the risk of hospitalization for upper GI tract bleeding is highest with rivaroxaban (Xarelto) and lowest with apixaban (Eliquis).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od4.html

Academy Gives Senate Strong Prescription to Improve MACRA

In recent Senate testimony, the Academy recommended key fixes for the framework of the Medicare Access and CHIP Reauthorization Act, including reducing complexity.

AAFP News : Advocacy and Government

https://www.aafp.org/news/government-medicine/20190515macrasenate.html

Simple Clinical Prediction Rule Determines Risk of Heart Failure with Preserved ...

May 15, 2019 - A simple clinical prediction rule using noninvasive data can identify patients at low, moderate, and high risk for HFPEF.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od3.html

CDC: Three in Five Pregnancy-related Deaths May Be Preventable

Sixty percent of pregnancy-related deaths in 2011-2015 for which timing was known were preventable, according to a new CDC Morbidity and Mortality Weekly Report.

AAFP News : Patient Care

https://www.aafp.org/news/health-of-the-public/20190515maternaldeath.html

Survey, FP Expert Agree: Interest in Telehealth on the Rise

Recently published results of a physician survey on telehealth indicate that use of the technology has quadrupled since 2015 and is expected to continue to increase in the years to come.

AAFP News : Practice and Career

https://www.aafp.org/news/practice-professional-issues/20190514telehealth.html

AAFP Recruiting for Ask and Act Office Champions Project

The AAFP is recruiting 20 family medicine practices to participate in its yearlong Reimagining Ask and Act Office Champions Project. Practices have until May 31 to apply.

AAFP News : Patient Care

https://www.aafp.org/news/health-of-the-public/20190508reimagineask-act.html

Policy Brief Makes Case for Funding Teaching Health Centers

Researchers find that family medicine residents who train in teaching health centers often practice in safety-net settings such as federally qualified health centers, rural health clinics, public health clinics, institutional clinics and clinics that are part of the Indian Health Service.

AAFP News : CME

https://www.aafp.org/news/education-professional-development/20190508thcfunding.html

Study Finds Family Physicians Offer More Value for Services

A comprehensive analysis of Medicare claims data revealed that on a per-patient basis, low-value care spending is less when care is provided by family physicians rather than by other primary care physicians.

AAFP News : Practice and Career

https://www.aafp.org/news/practice-professional-issues/20190508low-value.html

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