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Tapering Patients Off of Benzodiazepines - Curbside Consultation - American Family ...

Nov 1, 2017 - When prescribed at a low dosage for a short time (fewer than 30 days), benzodiazepines can effectively treat generalized and social anxiety, panic disorder, and sleep disorders. Long-term use for anxiety and sleep disorders is not supported by research because it is associated with the ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2017/1101/p606.html

Physician Burnout and Stress While Interacting with Patients - Curbside Consultation - ...

Nov 1, 2019 - Physicians, especially family physicians, face multiple stressors in modern medicine that can lead to disillusionment and burnout, which occur when the reality of practicing medicine does not match physicians' previous naive expectations.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/1101/p537.html

Communicating Risk to Patients Who Get Their Information from the Internet - Curbside ...

Sep 1, 2019 - What can physicians do when our patients act on findings from the internet?

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0901/p306.html

Helping Patients Cope with Grief - Curbside Consultation - American Family Physician

Jul 1, 2019 - The loss of a loved one, especially a spouse or a child, is perhaps one of the most difficult events a person will experience in a lifetime. The resulting grief can be overwhelming and incapacitating for a time. Family physicians can be sources of comfort to those who grieve the loss of...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0701/p54.html

An Unhappily Married Patient - Curbside Consultation - American Family Physician

Jun 1, 2019 - Overall, marriage enhances health. Men gain greater health benefits from marriage than their wives. Conversely, wives are more negatively affected by a bad marriage than their husbands. In general, the health benefit of marriage is maximized in a good marriage but negated in a bad ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0601/p708.html

Palliative Care in Advanced Dementia - Curbside Consultation - American Family Physician

Apr 1, 2019 - What is the best way for family physicians to determine prognosis and applicability of palliative care for patients with dementia?

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0401/p456.html

Effective Advocacy for Patients and Communities - Curbside Consultation - American ...

Jan 1, 2019 - Family physicians play diverse roles in society, often bridging individual and community perspectives. Family physicians' ethics require providing care to all persons regardless of their geographic, economic, political, racial, religious, or sexual orientation status.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0101/p44.html

Practical Considerations of Caring for Patients Abroad During Short-term Medical Trips ...

Dec 1, 2018 - A 65-year-old woman presented on the second day of my week-long volunteer medical brigade to a migrant camp in Mexico. The patient had a blood pressure of 180/110 mm Hg and a heart rate of 78 beats per minute. Her presenting symptoms were itchy eyes and sneezing, which she reported were...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2018/1201/p673.html

The Doorknob Phenomenon in Clinical Practice - Curbside Consultation - American Family ...

Jul 1, 2018 - By definition, the doorknob phenomenon or doorknob statement occurs when patients wait until the last moment in the clinical encounter—often while the physician is grasping the doorknob to exit the examination room—to utter something that, not uncommonly, provides crucial information. ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2018/0701/p52.html

Violence in the Health Care Setting: What Can We Do? - Curbside Consultation - American...

Sep 15, 2018 - n July 2017, Dr. Todd Graham was fatally shot by his patient's husband when Dr. Graham denied his patient's request for opioids. This case highlights that, according to the Bureau of Labor Statistics, health care professions are one of the most dangerous industries of employment in the ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2018/0915/p381.html

Clinical and Personal Utility of Genetic Risk Testing - Curbside Consultation - ...

May 1, 2018 - On April 6, 2017, the U.S. Food and Drug Administration (FDA) approved marketing of the 23andMe Personal Genome Service, the first direct-to-consumer genetic test. This test uses genomic DNA collected from mail-in saliva collection kits to provide information on a patient's genetic risk...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2018/0501/p600.html

Medical Aid in Dying - Curbside Consultation - American Family Physician

Mar 1, 2018 - Requests for hastened death are not unusual from patients with life-limiting illness, and many primary care physicians encounter these requests over the course of their career. Medical aid in dying is the practice of a physician providing a competent, terminally ill patient—at the ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2018/0301/p339.html

Female Genital Mutilation or Cutting - Curbside Consultation - American Family Physician

Jan 1, 2018 - FGM/C involves partial or total removal of the external genitalia or other injury to the female genital organs for nonmedical reasons. It is considered a human rights violation. It has no known health benefits, but many reported harmful consequences.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2018/0101/p49.html

Social Media Use and Mood Disorders: When Is It Time to Unplug? - Curbside Consultation...

Oct 15, 2017 - Americans spend more time on Facebook, the world's largest online social network, than any other website. On the surface, social media networks provide an invaluable resource for fulfilling the basic human need for social connection. However, rather than enhancing well-being by ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2017/1015/p537.html

Providing Trauma-Informed Care - Curbside Consultation - American Family Physician

May 15, 2017 - Family physicians commonly care for survivors of trauma, but they may not always realize it. Trauma, which can affect any patient regardless of age or sex, is broadly defined as the experience of violence or victimization, including sexual abuse, physical abuse, psychological abuse, ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2017/0515/p655.html

Patients with Disabilities: Avoiding Unconscious Bias When Discussing Goals of Care - ...

Aug 1, 2017 - False assumptions about patients' quality of life can affect prognosis, the treatment options that we present, and the types of referrals that we offer. In this case, the physician equated complex disability with terminal illness.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2017/0801/p192.html

Palliative Care Through Illness Trajectory - Curbside Consultation - American Family ...

Mar 15, 2017 - Persons with multimorbidity often have unmet multidimensional needs related to their health. For example, Y.S. may also be experiencing poorly controlled symptoms, financial distress, and increasing anxiety. His family is likely distressed by his decline in health and unsure about what ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2017/0315/p386.html

Pet Therapy: Enhancing Patient Care Through Time with Animals - Curbside Consultation -...

Nov 1, 2016 - A 16-year-old girl and her parents presented to my office for her wellness evaluation. The patient has generalized anxiety disorder with comorbid major depression, for which she has been prescribed a serotonergic antidepressant. She is a high school student, lives with her parents, and ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2016/1101/p737.html

Taking Care of Disadvantaged Patients - Curbside Consultation - American Family Physician

Jan 15, 2017 - No single person can be responsible for the health of a population. However, there are a number of strategies for taking care of members of disadvantaged populations. These range from targeted compassion and interventions for the individual patient to broad advocacy for disadvantaged ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2017/0115/p118.html

Helping Pregnant Women Keep Their Jobs - Curbside Consultation - American Family Physician

Sep 15, 2016 - At 7.5 months pregnant, my patient found herself increasingly uncomfortable at work. Her varicose veins ached from standing on the job, where she was required to work a cash register and walk prescriptions from the pharmacy to the checkout area. I wrote a note to her boss explaining ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2016/0915/p494.html

Challenges and Opportunities in the Care of Asian American Patients - Curbside ...

Oct 1, 2014 - In cases such as this, patients are often told, You don't need treatment now, but they only hear, You are fine. Subsequent failure to follow up may result from a combination of issues related to health literacy, educational attainment, linguistic barriers, and cultural differences.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2014/1001/p490.html

Caring for Patients with Job Insecurity Who Are Experiencing Chronic Work-Related Pain ...

Jul 15, 2016 - In addition to providing direct medical care, the physician can help this patient by obtaining an occupational history, formulating hypotheses about the cause of the pain and potential interventions, and establishing a therapeutic relationship.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2016/0715/p145.html

Evaluation of Behavior Change in Patients with Developmental Disabilities - Curbside ...

Apr 15, 2016 - A mother brought her 19-year-old nonverbal, autistic son to our clinic. She requested medication for him to reduce the number of episodes that include loud vocalizations, thrashing, and head banging. These episodes usually occur in the car. At baseline, the man has difficulty with ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2016/0415/p686.html

Late Presentation to Prenatal Care - Curbside Consultation - American Family Physician

Sep 1, 2015 - Pregnancy carries concrete and immediate risks that need to be addressed and managed in a timely fashion. Patients who initiate prenatal care late in pregnancy tend to present with a challenging variety of concerns, encompassing the full range of their medical, psychosocial, and ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/0901/p391.html

When Physician Family Members Are Involved in Patients' Care - Curbside Consultation - ...

Mar 1, 2016 - It is not unusual for physicians to care for patients who have physician family members. This can be advantageous for patients, their families, and the clinical team because physician family members often better understand the clinical situation, its severity, and the treatment options....

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2016/0301/p388.html

Addressing Suspected Labor Trafficking in the Office - Curbside Consultation - American...

Dec 15, 2015 - An estimated 18,000 persons are trafficked into the United States for labor each year. They most commonly originate from Latin America (31%), Southeast Asia (26%), and South Asia (13%), and 71% of persons enter on lawful visas. Health care may be one of the few fields in which ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/1215/p1092.html

Advance Directives: Navigating Conflicts Between Expressed Wishes and Best Interests - ...

Apr 1, 2015 - Clinicians and surrogates can be faced with challenging decisions when a patient loses the capacity to participate in medical decision making. A significant number of hospitalized and critically ill adults lose decision-making capacity during hospital stays and cannot make treatment ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/0401/p480.html

Menstrual Concerns in an Adolescent with Disabilities - Curbside Consultation - ...

Nov 1, 2015 - Clinicians who care for female adolescents with cognitive and physical disabilities are often consulted on the management of menstrual bleeding for purposes of hygiene, dysmenorrhea, and treatment of premenstrual symptoms. Contraception is also commonly discussed to mitigate pregnancy ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/1101/p823.html

Care of a Transgender Adolescent - Curbside Consultation - American Family Physician

Jul 15, 2015 - Although the actual number may be higher, research estimates that approximately 700,000 Americans are transgender. Many in this population have inadequate insurance to cover appropriate health care. Primary care clinicians treat transgender patients in their practices, and although not ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/0715/p142.html

Counseling Patients with Unintended Pregnancy - Curbside Consultation - American Family...

Apr 15, 2015 - Nearly one-half of all pregnancies in the United States are unintended. Risk factors for unintended pregnancy include limited access to contraception, less than a college education, poor social support, age between 20 and 24 years, and black race. Family physicians are often the initial...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/0415/p574.html

Caring for Muslim Patients Who Fast During Ramadan - Curbside Consultation - American ...

May 1, 2015 - A 68-year-old Muslim man who was recently diagnosed with type 2 diabetes mellitus presented for a routine health visit. His initial A1C level was 8.2%, which decreased to 6.7% after dietary changes, exercise, and treatment with metformin (Glucophage). He stated that he wanted to fast ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/0501/p640.html

Screening for Hereditary Cancer Syndromes - Curbside Consultation - American Family ...

Jan 15, 2015 - Family physicians play a key role in identifying patients in need of increased cancer surveillance because of a personal or family history of cancer. How does one know if a patient warrants genetic testing for hereditary cancer predisposition?

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/0115/p125.html

Caring for Unaccompanied Minors from Central America - Curbside Consultation - American...

Nov 1, 2014 - The surge of unaccompanied minors from Central America crossing the United States–Mexico border in recent months has made national headlines, creating an urgent humanitarian situation. The reasons for this migration are multifactorial, and the resultant politics are deeply complex.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2014/1101/p656.html

Complex Care: Treating an Older Patient with Multiple Comorbidities - Curbside ...

Mar 1, 2014 - Although there are guidelines for management of single chronic illnesses, the evidence base for management of multiple comorbidities is lacking. The American Geriatrics Society described a clinical approach to managing patients with multiple comorbidities in 2012.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2014/0301/p392.html

Ethical Use of Diagnostic Technology: Balancing What's New and What's Necessary - ...

Jul 1, 2014 - This case boils down to being realistic about what new screening tools and techniques can and can't do, and understanding their actual value in diagnoses. I'd argue that it is not unethical to accommodate a patient's requests, as long as the physician's approach to the patient, the ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2014/0701/p53.html

The Hospice Referral - Curbside Consultation - American Family Physician

May 1, 2014 - Hospice is a program of care and support for persons facing life-limiting illnesses. Hospice care involves a team-oriented approach to medical care, pain management, and emotional and spiritual support expressly tailored to the patient's needs and wishes.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2014/0501/p745.html

Breaking Bad News Over the Phone - Curbside Consultation - American Family Physician

Sep 1, 2009 - As a general rule, it is preferable to give test results to your patients in person.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2009/0901/p520.html

Talking with Children About a Parent's Serious Illness - Curbside Consultation - ...

Nov 1, 2013 - It is not uncommon for children to have parents who have cancer. Although parents may be understandably apprehensive about discussing a serious illness, children want and need to know what is happening. It is strongly recommended that children be involved and informed in the illness and...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2013/1101/p570.html

Inheriting Patients with Questionable Medication Regimens - Curbside Consultation - ...

Jan 1, 2014 - Inheriting a patient on an inappropriate or questionable medical regimen is a scenario that every physician confronts when practicing continuity care. It can present frustrating challenges, especially for resident physicians, who, because of the nature of training programs, care for ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2014/0101/p44.html

Treating Patients with Borderline Personality Disorder in the Medical Office - Curbside...

Jul 15, 2013 - The prevalence of borderline personality disorder in the general population is thought to be between 1% and 2%. As family physicians, we often treat these patients for chronic medical conditions. There are multiple obstacles to caring for these patients because of their difficult ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2013/0715/p140.html

Undetected Childhood Sexual Trauma and Its Health Effects in Adults - Curbside ...

Sep 1, 2013 - It is essential for physicians to understand the relevance of childhood sexual trauma to adult medical conditions. Recognizing this connection can help physicians begin to manage the resulting damage. Exposure to childhood sexual trauma is highly prevalent in the United States, but is ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2013/0901/p328.html

Caring for Older Patients Who Have Significant Hearing Loss - Curbside Consultation - ...

Mar 1, 2013 - This scenario illustrates issues related to end-of-life care and placement in a long-term care facility for older individuals with significant hearing loss. An analysis of data from the 1999 to 2006 cycles of the National Health and Nutrition Examination Survey, and statistics from the ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2013/0301/p360.html

Caring for Colleagues, VIPs, Friends, and Family Members - Curbside Consultation - ...

Jun 1, 2013 - There may be no higher professional honor than being asked to care for a colleague, a very important person (VIP), a friend, or a family member. However, these requests can be problematic if they are not addressed properly. The following strategies can help physicians avoid pitfalls ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2013/0601/p793.html

Demoralization: A Precursor to Physician Burnout? - Curbside Consultation - American ...

Nov 1, 2012 - Demoralization is a state of hopelessness and helplessness that is akin to, but separable from, depression.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2012/1101/p861.html

Care of a Sexually Active Adolescent - Curbside Consultation - American Family Physician

Sep 1, 2012 - The American Medical Association's Principles of Medical Ethics clearly state that physicians shall safeguard patient confidences and privacy within the constraints of the law. However, the laws in American jurisdictions vary with respect to a minor's ability to consent to medical ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2012/0901/p457.html

Evaluating and Treating Sexual Addiction - Curbside Consultation - American Family ...

Jul 1, 2012 - This patient’s behavior is concerning because of ongoing compulsive behavior despite significant repercussions in his home and work life. Sexual addiction has been described as a behavioral addiction (similar to gambling), a compulsive disorder (similar to obsessive-compulsive ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2012/0701/p74.html

Determining Prognoses for Patients with Terminal Illnesses - Curbside Consultation - ...

Jun 1, 2006 - Physicians often overestimate a terminal patient's life expectancy.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2006/0601/p2062.html

Flaws in Clinical Reasoning: A Common Cause of Diagnostic Error - Curbside Consultation...

Nov 1, 2011 - Many medical errors have been identified as systemic and addressed with interventions, such as checklists. However, a substantial number of errors that occur in diagnosis and treatment are attributed to flaws in clinical reasoning.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2011/1101/p1042.html

A Case of Medical Uncertainty - Curbside Consultation - American Family Physician

Mar 1, 2012 - Medical uncertainty (i.e., not knowing how to proceed with a patient-related problem) can stem from any number of potential situations in daily clinical practice. The causes of uncertainty are many, but the feeling of stress or discomfort it creates is a familiar constant, though it may...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2012/0301/p501.html

Primary and Subspecialty Care: Building a Collaborative Relationship - Curbside ...

Feb 1, 2012 - For the referring physician, proper etiquette includes identifying the clinical reason for the referral, confirming the appropriateness with respect to the subspecialty, providing the subspecialist with accurate and timely information, and maintaining an open and effective line of ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2012/0201/p279.html

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