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Family physicians perform high-quality colonoscopies, but access is an issue

Common Sense Family Doctor

Most patients who choose colonoscopy as a screening test for colorectal cancer are referred from primary care to a gastroenterologist or other specialist who performs endoscopy. But that wasn’t the case for the estimated 1 in 15 US patients whose screening colonoscopies were performed by family physicians in 2021.

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EMS Intervention to Reduce Falls: Carmen Quatman and Katie Quatman-Yates

GeriPal

The insight started when Carmen, an orthopedic surgeon-researcher, and Katie, a physical therapist- researcher participated in ride-alongs with EMS providers to patient’s homes. Going into patient’s homes was eye opening. So Carmen and Katie developed an EMS Community Partnership program. Word of mouth spread rapidly.

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Dementia and high risk surgery: Joel Weissman and Samir Shah

GeriPal

You have a patient with dementia severe enough that she cannot recognize relatives. Should she have an operation, and risk the pain, potential complications, and attendant delirium associated with the operation? Samir: For me, it really came out of an interest in improving the care of patients who undergo surgery. AlexSmithMD.

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RCT of PC in ED: Corita Grudzen, Fernanda Bellolio, & Tammie Quest

GeriPal

I asked emergency medicine clinicians what they thought when a patient who is seriously ill and DNR comes to the ED, and some responded, (paraphrasing), what are they doing here? Most emergency providers wanted to do the right thing for seriously ill patients, but they didnt have the knowledge, skills, or experience to do it.

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PC Trials at State of Science: Tom LeBlanc, Kate Courtright, & Corita Grudzen

GeriPal

And we have Kate Courtright, who’s at University of Pennsylvania, the PAIR Center. What we did was ask clinicians earlier in the ICU stay for very sick patients to document prognosis, and for those who they thought would survive, to document six-month functional prognosis. Kate: These are very sick patients. Kate: Sure.

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Palliative care for cancer: Podcast with Jennifer Temel and Areej El-Jawahri

GeriPal

But at that time I was struck by how in that field, there wasn’t a focus or really interest in symptom management and support for patients and their families. Eric: And what a research agenda that you’ve done, including one of the most seminal papers that we have in palliative care in lung cancer patients.

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Storytelling in Medicine: A Podcast with Liz Salmi, Anne Kelly, and Preeti Malani

GeriPal

Liz wrote a fabulous perspectives piece in the NEJM titled “ Deciding on My Dimples ” which talks about her experience as a patient doing shared decision making during neurosurgery for resection of an astrocytoma. But my piece in the New England Journal is about being a patient right before awake brain surgery.

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