March 2014

Upper Chest Wall Lesion in a Middle-aged Woman

March 18, 2014

Dermatology Quiz

A 58-year-old woman presented to clinic with concerns about this skin lesion on her upper chest. She reports it has been present for 1 year and is slowly enlarging. The lesion is otherwise asymptomatic and her past history is only significant for rheumatoid arthritis (RA), for which she takes methotrexate and etanercept.

With Telehealth Connections to Pain Specialists, Prescriptions for High-Dose, Short-Acting Opioids Decline

March 18, 2014

The HIT List

In a recent pilot study, primary care providers (PCPs) who regularly consulted with pain management specialists through telehealth technology wrote fewer prescriptions for the high-dose, short-acting opioid analgesics that are widely associated with greater rates of addiction and overdose.

Poor Functioning, Costly EHRs Not Worth the Effort for Family Physicians

March 17, 2014

The HIT List

Nearly two-thirds of family physicians would not purchase their current electronic health record (EHR) system again due to poor functionality and high costs, according to new data that discovered alarming disconnect between care providers' health information technology needs and the present state of EHR technology.

Introduction to Pain Perspectives

March 14, 2014

Pain Perspectives

Since family physicians are more likely to adhere to a patient-centered biopsychosocial model than specialist physicians who treat chronic pain, primary care seems to be the logical "home" for its treatment.

Let the Buyer Beware of Direct-to-consumer Advertising

March 10, 2014

Editor's Letter

Whether direct-to-consumer advertising is a good or bad thing remains a matter for debate, but what is not up for discussion is the need for due diligence on the part of physicians in managing patients who are motivated by those ads to seek medical attention.

Can a Smoking Cessation Drug Cause Neuropsychiatric Adverse Events?

March 07, 2014

FPR Journal Club

When encouraging and supporting patients to quit smoking, varenicline is unlikely to increase the risk of neuropsychiatric adverse events such as suicide, depression, and aggression, even in patients with pre-existing psychiatric illness.

Finding Red Flags for Spinal Fracture, Malignancy in Low Back Pain

March 06, 2014

FPR Journal Club

Older age, chronic corticosteroid use, severe trauma, abrasion, or some combination of red flags predict an increased risk of spinal fracture, but a prior history of malignancy is the only useful predictor of spinal malignancy.

Do Patient-centered Medical Homes Really Improve Primary Care Quality?

March 04, 2014

FPR Journal Club

One patient-centered medical home pilot was associated with improvement in only one of 11 quality areas and was not associated with reductions in hospital utilization or costs of care over 3 years.

Access to Firearms Raises Suicide, Homicide Risk

March 04, 2014

FPR Journal Club

Family physicians should screen all patients for domestic violence, counsel those at risk on safe havens and the dangers of living in a home with a handgun, and encourage safe gun ownership practices.