J Am Board Fam Med
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Cardiovascular disease is a leading cause of morbidity and mortality in the United States. Since their initial discovery, statins have become the first-line treatment for decreasing the risk of cardiovascular disease. Although they are typically well tolerated, side effects do occur and tend to affect the musculature. ⋯ This case report details the case of a 54-year-old woman who developed anti-HMGCR myopathy after several years of uncomplicated statin use. Differences between other reported cases and this 1 are discussed, including the patient's strong response to steroid therapy which resulted in the normalization of her serum creatinine kinase and alleviation of her muscle weakness. This case highlights the need for clinicians to be aware of anti-HMGCR myopathy and to consider it as a potential cause of proximal muscle weakness and persistent serum creatinine kinase elevations in patients exposed to statins even if they were previously well tolerated by the patient.
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The American Academy of Family Physicians has 72,600 active members and a robust continuing medical education platform. A foundational principle of their work is an assumption of an intrinsic motivation of physicians to learn in order to better take care of their patients and communities. This commentary presents their vision of individualized learning portfolio in which individual family physicians utilize data to identify their gaps of knowledge and performance over time and use a varirty of CME, including performance improvement, to address and lessen those gaps, with the Academy serving as a navigator and facilitator, all while supporting intrinsic motivation to learn and improve.
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The American Board of Family Medicine (ABFM) is exploring the development of an ABFM Journal Club as a part of its continuing certification portfolio. To benchmark this effort, we reviewed the journal article activities of 8 other American Board of Medical Specialties boards. ⋯ A National Journal Club Committee will choose the top 100 articles based on methodologic rigor, generalizability and relevance to family medicine, and potential to change practice. A postactivity assessment instrument will require mastery learning of new clinical findings and support deeper learning, with the goal of supporting personal physicians in keeping up to date and informing shared decision-making.
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Review
Practical Management of Common Skin Injuries, Lacerations, Wounds, Trigger Fingers, and Burns.
Primary care clinicians encounter many conditions during their day-to-day visits with patients. A few of these common presentations include burns, lacerations, trauma to the hand, and wounds, some of which do not require an evaluation by a specialist and can be managed outpatient by primary care clinicians. In this article, we share evidence-based tips to avoid common pitfalls in primary care recognition and management of such presentations as well as guide them to manage many of these conditions themselves. We also provide guidance in the decision to refer the patient to a plastic surgeon or other specialists.
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To understand the motivations of rural-practicing primary care clinicians who participate in an intensive multiyear pragmatic randomized behavioral obesity intervention trial, Rural Engagement in Primary Care for Optimizing Weight Reduction (RE-POWER). ⋯ Our findings show that clinicians are motivated to try solutions for a clinical problem-in this case obesity-when that clinical problem is also closely connected to a particularly frustrating area of clinical care that challenges their professional identity. Our data suggest that a motivation to close the gap between ideal and real practice can become such a high priority that clinicians are sometimes willing to try potential solutions, such as engagement in research, that they otherwise would not consider.