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

A Country Doctor Writes

Its basic argument was that it isn’t sustainable to only see patients one by one in traditional doctor visits. I thought of it the other day when I put together a presentation about Galileo’s way of interacting with patients. The physician–patient encounter is health care’s choke point.

Patients 130
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Revisiting the Advantages of aSOAP Notes: The Best of the Paper Chart and Old School Photography

A Country Doctor Writes

We may only have 15 minutes with each patient. In primary care it is often necessary to think in terms of including more than our area of interest in our mental picture of our patient. My system lets me choose whether to import everything or essentially nothing from the patient’s past medical history.

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Racial and Disaggregated Ethnic Disparities of Blood Pressure Control in Community Health Centers [Hypertension]

Annals of Family Medicine

Context: Hypertension is the most prevalent reversible risk for cardiovascular morbidity and mortality. Blood pressure (BP) control (<130/80 systolic/diastolic) is poor nationally, and is inequitable by race/ethnicity, with minimal understanding of the differences within Latino patients by country of origin.

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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.

Patients 130
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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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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. Who is the patient?

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Subclavian Steal Syndrome

Vascular Physician

Medications to use include controlling dyslipidemia, hypertension, and diabetes along with antiplatelet therapy. Patients with burdensome symptoms and occlusive disease can be managed by a vascular surgeon, either with open surgery or percutaneously.