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“The physician–patient encounter is health care’s choke point” -NEJM

A Country Doctor Writes

I thought of it the other day when I put together a presentation about Galileo’s way of interacting with patients. And, as the NEJM article points out, there are no financial incentives to have nurses or other non-providers manage routine problems like hypertension in our current system. These approaches will improve with time.

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Revisiting the Advantages of aSOAP Notes: The Best of the Paper Chart and Old School Photography

A Country Doctor Writes

Or it may look like these examples: 60 year old male with hypertension, COPD and anticoagulated atrial fibrillation returns for followup. 72 year old female with diabetes and heavy atherosclerotic burden presents with two weeks of increased dyspnea and weight gain as well as increased thirst and episodes of blurry vision.

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Approach to steatotic liver disease in the office: Diagnosis, management, and proposed nomenclature

Canadian Family Physician

Known complications of metabolic syndrome and advanced liver disease are often present at the time of diagnosis. Subtle differences are present among patients diagnosed with SLD. Diagnosis relies on noninvasive tests. Courses of action should include assessment of cardiometabolic risk factors and progressive liver dysfunction.

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Nutrition, Heath Equity, and CV Mortality with Dr. Kim Williams

Louisville Lectures

Our new Chair of the Department of Medicine, Dr. Kim Williams, presents his first Grand Rounds on the topic of Nutrition, Health Equity, and CV Mortality. First, Dr. Williams discusses some of the main issue in the United States including being its expensive and broken healthcare system. Williams Sr, M.d., Williams Sr.,

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Problem Representation

The Clinical Problem Solvers

The defining features of a case can include key or differentiating features (see more details and examples here ): Key feature : a feature that is present consistently and ideally exclusively in the condition. Differentiating feature : a feature shared among other similar conditions but not present in many diseases.

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Drinking the Disease: Arsenic Exposure in Well Water from the Perspective of Patients and Providers [Social determinants and vulnerable populations]

Annals of Family Medicine

Chronic exposure has been associated with diabetes mellitus, hypertension, skin cancer, renal, bladder and lung cancers, polyneuropathy, and QT prolongation. This is the first study elucidating clinician knowledge on the risk and symptomatic presentation of patient arsenic exposure from well water.

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How to Prevent a Potentially Fatal Aortic Dissection

Vascular Physician

How to Prevent a Potentially Fatal Aortic Dissection High blood pressure is a well-known medical condition that many people understand is a risk factor for heart attacks, strokes, and diabetes. Unfortunately, high blood pressure does not always present with symptoms that are noticeable by the patient.

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