afpjournal.blogspot.com
The AFP Community Blog: April 2015
http://afpjournal.blogspot.com/2015_04_01_archive.html
Monday, April 20, 2015. Does every discharged patient need close outpatient follow-up? Jennifer Middleton, MD, MPH. Reducing unnecessary readmissions has been of increasing interest to hospitals and health systems, but, until recently, no evidence base supported the current Medicare strategy of incentivizing outpatient follow-up within 30 days of discharge. Annals of Family Medicine. Showed that this strategy is beneficial, but only for patients with multiple chronic conditions. Ength of stay, A. It may ...
afpjournal.blogspot.com
The AFP Community Blog: The SGR is history, but will its replacement improve care?
http://afpjournal.blogspot.com/2015/04/the-sgr-is-history-but-will-its.html
Wednesday, April 15, 2015. The SGR is history, but will its replacement improve care? Kenny Lin, MD, MPH. Last night, the U.S. Senate overwhelmingly passed the Medicare Access and CHIP Reauthorization Act of 2015. Instead of cuts, physicians will now receive annual 0.5% increases to payment schedules through 2019, after which payments will be designed to reward quality over quantity of care. As many have pointed out. To provide a service. That's a big problem, since the original intent of the SGR was...
afpjournal.blogspot.com
The AFP Community Blog: August 2014
http://afpjournal.blogspot.com/2014_08_01_archive.html
Monday, August 25, 2014. Who is defining Family Medicine? Jennifer Middleton, MD, MPH. Perhaps you've already heard - a cardiologist raised the profile of family physicians last week. National Public Radio's Fresh Air program interviewed Dr. Sandeep Jauhar, a cardiologist working in New York City, August 19. And he had this to say about family physicians:. This particular piece of the interview reminded me of a powerful editorial written a few years ago in the Annals of Family Medicine. Will we continue ...
afpjournal.blogspot.com
The AFP Community Blog: Palliative care at the end and the beginning of life
http://afpjournal.blogspot.com/2015/03/palliative-care-at-end-and-beginning-of.html
Tuesday, March 31, 2015. Palliative care at the end and the beginning of life. Kenny Lin, MD, MPH. Published earlier this year in the Annals of Internal Medicine. Reported that patients and their caregivers were more likely to report pain, depression, and periodic confusion during the last year of life in 2010 than in 1998. This worsening trend occurred despite increasingly frequent calls to improve end-of-life care communication. And the American College of Physicians. She helped us understand the decis...
afpjournal.blogspot.com
The AFP Community Blog: Acetaminophen ineffective for chronic low back pain - now what?
http://afpjournal.blogspot.com/2015/04/acetaminophen-ineffective-for-chronic.html
Monday, April 6, 2015. Acetaminophen ineffective for chronic low back pain - now what? Jennifer Middleton, MD, MPH. Acetaminophen has been a mainstay of treatment for chronic low back pain (LBP) for years, but a recent study turns that conventional wisdom on its head. In a meta-analysis that was published in the BMJ. Intuitively, acetaminophen seems like a reasonable choice for treating chronic LBP. It's inexpensive and relatively safe when used at recommended doses. A 2009 AFP. Advises a trial of acetam...
afpjournal.blogspot.com
The AFP Community Blog: Another strike against NSAIDs?
http://afpjournal.blogspot.com/2013/07/another-strike-against-nsaids.html
Monday, July 1, 2013. Another strike against NSAIDs? Jennifer L. Middleton MD, MPH. One of the issues family docs deal with on a daily basis is pain control. I usually think about pain medication as falling into one of three categories: acetaminophen, NSAIDs, and opioids. I frequently recommend acetaminophen, but patients often tell me "it's not strong enough for me" (maybe an unintentional consequence of those commercials touting Tylenol's gentleness. Perhaps you've already heard about The Lancet. Inclu...
afpjournal.blogspot.com
The AFP Community Blog: PSA screening by the numbers: no benefits, many harms
http://afpjournal.blogspot.com/2015/05/psa-screening-by-numbers-no-benefits.html
Monday, May 4, 2015. PSA screening by the numbers: no benefits, many harms. Kenny Lin, MD, MPH. Previous studies found that two-thirds of men who receive prostate-specific antigen (PSA) screening for prostate cancer didn't have shared decision making. These findings, along with a Cochrane review. And another systematic review. In 2012. Since then, the American Academy of Family Physicians and the American College of Preventive Medicine have added this service to their Choosing Wisely. Clearly illustrates...
afpjournal.blogspot.com
The AFP Community Blog: December 2014
http://afpjournal.blogspot.com/2014_12_01_archive.html
Monday, December 22, 2014. Screening for developmental dysplasia of the hip: when organizations disagree. Jennifer Middleton, MD, MPH. If your medical education was anything like mine, chances are you learned to incorporate hip testing into every newborn exam, but the evidence base to support that common practice is uncertain. " Common Questions About Developmental Dysplasia of the Hip. An article in the December 15 issue of AFP. The AAFP concurs with the USPSTF. To recommend routine screening for develo...
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