Annals of Family Medicine

NOVEMBER 20, 2024

Context: The Transitional Care Management (TCM) clinic visit is a uniquely billed visit type to review a recently discharged patient’s hospital course, reconcile medications, and continue ongoing workup. Referrals were not placed for patients being discharged to another facility or who already had an outside primary care provider.

Appointment 130

Appointment Hospital Management Family Medicine 130

Dr. Zaar

JUNE 1, 2025

Managing Type 2 diabetes requires more than just medication—it demands a long-term partnership with a skilled healthcare provider who understands your individual needs. Choosing the right diabetes doctor can make a major difference in how effectively your condition is managed, your quality of life, and your long-term health outcomes.

Diabetes 52

Diabetes Board-Certified Management Internal Medicine 52

Physician's Weekly

JUNE 25, 2025

Many of these patients are clinically complex and receive care from multiple professionals—which creates unique management hurdles. Even within practices, some staff members may not be aware of which patients require more proactive management due to multiple chronic conditions. Have open gaps in care or medications not filled.

Chronic Condition 59

Chronic Condition Patients Management Primary Care Physician 59

GeriPal

SEPTEMBER 7, 2023

So I would say that a lot of the education we received were on cutting edge research and the latest drugs in clinical trials, the latest cellular therapies that are coming out. So pretty soon, I hope, we’ll be able to do this all electronically by anyone who wants to. Or electronically, to fill out, right? Mazie: Yes.

Patient-Centered 129

Patient-Centered IT Patients Clinic 129

GeriPal

JULY 21, 2022

Emmy: So I think shifting that a little bit is what helped me do a lot of the education that I do to therapists and physicians, just to have it on their radar. ” So some of it is education around driving habits and ways of getting places also. Or have electronic health record prompts so people remember to ask it?

Families 102

Families Family IT Diagnosis 102

GeriPal

APRIL 6, 2023

Practice-PC is an intentionally interprofessional and cutting edge year-long group continuing education course in palliative care for working professionals from all disciplines, in the Bay Area. In addition to that long list, I was also a chaplain educator. It meets in-person, once a month, over nine sessions. Where are my colleagues?”

IT 99

IT Patient-Centered Families Family 99

GeriPal

SEPTEMBER 19, 2024

And now when I think about the clinic at Duke, when we’re really running on all cylinders, we can get ourselves up to a five, six, seven week wait for a new palliative care referral. It’s not just about physical symptom management. I don’t know if we captured where the hospice referral came from. Stupid theory.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119