Did I Miss a Better Peripheral Neuropathy Treatment?

In March, I shared a case of a woman with diabetes-related peripheral neuropathy to highlight issues of pain management in primary care. To recap: Maria, age 68, had been experiencing burning pain sensations in her feet and ankles for the past 3 years. I decided to prescribe duloxetine, and I asked for and received feedback … Read more

Treating Frail Patients Requires ‘Precision Gerontology’

An estimated 15% of Americans over age 65 who aren’t living in institutions are considered frail — a complex geriatric syndrome that raises the odds of disability, hospitalization, the need for nursing care, and death. But while the word frailty may conjure images of wizened and weakened men and women, the clinical picture is far … Read more

What’s the Most Likely Cause of This Man’s Severe Headaches?

A 35-year-old man comes to clinic for evaluation of new, severe headaches. He reports that these started 3 days ago. His headache is worse when he stands, and resolves when he lies down. Valsalva maneuver makes the headache much worse. The headaches are present in the occipital region. He has also noticed the onset of … Read more

ETSU behavioral health program looks to set model for providing care | Health Care

When East Tennessee State University recruited Dr. Jodi Polaha to Johnson City in 2006, her work in Nebraska integrating behavioral health services into primary care was a big reason why. It wasn’t until recently, however, that Polaha and her colleague, Dr. Matthew Tolliver, began working with an eye toward building a model that could be … Read more

Disparities Shrink With Aggressive Depression Screening

An analysis at a large academic health system suggests that universal screening might help to reduce problematic disparities in depression treatment. The study began soon after the US Preventive Services Task Force recommended depression screening for all adults in 2016. The task force based this recommendation on evidence that people who are screened and treated … Read more

Lynchburg-area students, doctor start art project to support terminal patients | State and Regional News

RACHAEL SMITH The (Lynchburg) News & Advance FOREST — It’s inevitable that physicians eventually will have to deliver bad news to their patients, old and young — including, sometimes, that the patient has been diagnosed with cancer or another terminal illness. Dr. Andrew Anderson, owner Boonsboro Direct Primary Care—soon to be renamed Kaya Health—said it … Read more

Hospitalists and PCPs Crave Greater Communication

Decades after hospitalists took over inpatient care in the 1990s, hospitalists and primary care physicians (PCPs) still struggle with a communication divide, researchers at one teaching hospital found. Hospitalists and PCPs want more dialogue while patients are in the hospital in order to coordinate and personalize care, according to data collected at Beth Israel Deaconess … Read more

Determining PA Scope of Practice Using EPAs

In the ongoing conversation about physician assistant/associate (PA) practice, there is a theme of understanding when an individual provider can see specific patient populations and various complexities. Determining when PAs can be expected to make diagnoses and treat a patient population based on their education and experience is key to granting a scope of practice. … Read more