Commentary Archive

Recertifying from inactive status

For the APN who is recertifying, it is important to establish relationships with other APNs at the local and national level.

What our words say about ourselves

The words that we use and how we use them ultimately reflect what we think of ourselves.

Collaborating on interventional pain management in primary care

Interventional pain specialists can work together with primary care providers to provide the best care for patients managing chronic pain.

Keep the care in care coordination

In a patient-centric model of care, the effort focuses on the patient's wishes.

ICD-10 codes may improve asthma care

The new ICD-10 coding system may seem inappropriate for some disease models, but asthma care may benefit from the required changes.

Full practice authority and opiate use

Federal law does not allow nurse practitioners and physician assistants to prescribe buprenorphine to patients with opiate use disorder.

The flu shot remains a vital healthcare tool

Even if the flu shot "misses," as it did last year, it remains one of the best tools we have to help our patients live healthier lives.

Basal insulin for surgical diabetic patients

Basal insulin, with or without nutritional correction, is the best approach to manage blood glucose in noncritically ill surgical patients.

Staying well while caregiving

Caregivers experience serious chronic health conditions at nearly twice the rate of those who are not caregivers.

Narcotic abuse in the emergency department

Providers need to address the overuse of prescription narcotics in the emergency room.

Star power in medicine

Encourage patients to determine the validity of outside sources for medical advice.

Discuss advanced care planning with patients

Primary care providers and physicians should address advanced care planning with their patients.

Psychotropic medication use in children

Whether to prescribe psychotropic medications in children with anxiety and sleep disorders is a common ethical dilemma faced by primary care providers.

Communicating vaccine safety to parents

Clinicians should inform parents about the safety of vaccines to encourage them to vaccinate their children.

Providing health care as a parent

Becoming a parent can provide a new perspective for health care providers working in pediatrics.

Reducing ethnic disparities in cancer care

Addressing and overcoming barriers would increase the use of preventive health services and decrease mortality rates for the African American community.

Tips for reducing needlestick pain in children

Primary-care providers should try to ease pediatric patients' anxiety about needles by preparing them for what to expect.

January and you still have head lice!

Head lice cases peak in September and January in schools, and treatment can be difficult.

Don't fumble the patient hand-off

Although technology might have weakened the idea that verbal patient hand-offs are important, such exchanges remain key to patient care.

Try these five tips for avoiding burnout

Prevention of burnout is the key to avoiding its harmful consequences.

A different look at lipids

The first step in reducing the risk of cardiovascular disease is for health-care professionals to get a full understanding of a patient's risk.

Debunking diabetes nutrition, carbohydrate myths

The Grain Foods Foundation explores popular carbohydrate-related myths and assumptions patients with diabetes have likely encountered.

Keep an eye out for depression

Females are more likely to have suicide attempts; males are more likely to have completed suicides.

Softening the blow of a diabetes diagnosis

Help patients direct their energy into positive behaviors to manage their diabetes.

Put on your own oxygen mask first


Clinicians should carve out self-reflection time, even if it starts with just 5 minutes a day of pure silence.

Help children keep asthma at bay

Begin to impart asthma information to young patients and/or their caregivers as early as possible.

End-of-life talks in primary care

Health practitioners need to be prepared, and help prepare patients for end-of-life discussions.

Distorted body image not just a girl problem

Clinicians are seeing more boys with eating disorders and/or complications related to inappropriate diets, supplement use and steroid use.

My patient, myself? Not always!

How should you answer when a patient asks, "What would you do if you were me?"

Obesity: A preventable risk factor for cancer?

Obesity is a well known risk factor for diabetes and cardiovascular diseases but also for many types of cancer.

Managing speech-delayed patients

Screening for speech deficiencies at each visit can identify potential delays and target interventions to achieve milestones.

Why dietary-protein intake matters

Ensure your patients' dietary protein intake meets recommended levels of 10% to 35% of caloric intake.

Nephrotoxic medications for patients on dialysis

Can drugs that are contraindicated in patients with severe renal impairment be used in individuals with ESRD who are actively receiving hemodialysis?

HIV complacency can be deadly

It's been 32 years since the CDC published the first HIV case report, and too many Americans no longer view the disease as a serious illness.

We can impact the obesity epidemic

Providing weight-loss guidance on an ongoing basis to your patients can make a difference in the nation's war on obesity.

How to just say 'no' to a patient

Paying attention to patients' instincts is important, but clinicians should be aware appropriate ways to say "No" to a demanding patient.

Retail medicine: A final sale?

On the surface, the emergence of so-called "retail medicine" fills a niche. In reality, the concept may be more controversial.

Colonoscopy tips from the front lines

We can empower colonoscopy patients with a few written instructions to help ensure the procedure is safe and has optimal outcomes.

The politics of the greater good

Legislators count on different types of healthcare providers to give them accurate info and suggestions for improvements, but many have their own agenda.

Brush up on oral-health screening

Dental care is often cited among the greatest unmet health need of children. Primary care providers can help solve this problem.

Adressing obesity head-on

Weight is one of the toughest topics to discuss with patients, but we can no longer avoid it as the obesity epidemic grows.

Desperation leads patients online for Rx meds

Clinicians must carefully question our patients about the source of their prescription drugs to make sure they are obtaining these products from legitimate sources.

Infant safety: Part of the primary-care job

Primary-care clinicians need to educate parents of young children on dangers such as suffocation, car safety, falls, burns and choking.

Should deconditioning be a stand-alone diagnosis?

Deconditioning -- a complication of POTS -- is also a common cause of morbidity and mortality in preventable diseases such as obesity.

Are we really ready to innovate?

It seems everyone wants a solution to the primary-care doctor shortage, but few are really ­interested in significant change when it affects them.

Do family meals make a difference?

People who participate in frequent family meals are more likely to get healthy and stay healthy.

Selling your patients on health

Proactive disease prevention and health-promoting patient education is a hallmark in the venue of primary-care providers.

Help kids who are bullied or bullies

Bullying can begin as early as kindergarten, and it can affect all children regardless of race, gender and socioeconomic status.

Social media in medicine is here to stay

About 34% of consumers in a 2012 survey reported using social media to search for health information.

EHRs: It will get better!

One day health-care providers will wonder how we could have possibly ever gotten by without EHRs.

Pros and cons of home genetic testing

Is it a good thing or a bad thing when laypeople are able to order their own genetic profiles and interpret their own results?

Don't let patients tan their lives away

Teen girls will come up with 100 reasons to use tanning beds. We as health-care providers need to give parents one really big reason to say no.

Patient-centered palliative care often elusive

A layer of bureaucracy in health care exists in which insurance regulators determine where a patient will die based on information from well-intentioned but inexperienced nurse case managers.

Will physician assistants and nurse practitioners ever belong?

Despite the positive inroads and contributions that physician assistants and nurse practitioners have made over the past decades, we still face professional opposition.

Prescribing pain meds the right way

Just 8% of participants in a study assessing how primary care patients who are prescribed opioids are tracked underwent urine testing, only half made regular visits to their prescribers and 23% received more than one early opioid refill.

What to remember when job hunting

Employment opportunities are limited today for many people seeking work, yet health-care needs are on the rise and the demand for nurse practitioners (NPs) and physician assistants (PAs) to care for the country's baby-boomers is increasing.

Personal liability insurance offers clinicians portability, access to risk-management tools

As physician assistants and nurse practitioners continue to grow in numbers, so have medical malpractice claims against them. It may be time to consider carrying personal professional-liability insurance policy.

High on bath salts: what to know

"Bath salts" are new synthetic drugs that are typically found as white, light tan or brown powders, believed to contain psychoactive chemicals known as mephedrone and/or methylenedioxypyvrovalerone.

Step up, speak out — for your own sake

Politics, laws, rules and regulations are the very core of what drives what clinicians can and can't do; it determines reimbursement and therefore your salary. To be blissfully unaware is lazy. To be aware and completely uninvolved is just shameful.

Adolescents need HPV shots early

Common reasons that parents give when declining human papillomavirus vaccine for their children are, "My teen is not sexually active," or "Maybe we'll wait until he/she is a bit older." This thinking negates the vaccine's preventive purpose.

The 100-day cough: clinicians be(a)ware

Only 5.9% of eligible candidates receive the recommended pertussis booster vaccine, and the disease remains one of the leading causes of vaccine-preventable deaths worldwide.

Extended proton pump inhibitor use: Is it safe?

What are the consequences of taking proton pump inhibitors (PPIs) over an extended period of time?

Professionalism doesn't wear sweats

Is professionalism in medicine on the decline? A few months ago I saw a new patient who had transferred from another practice because the physician there wore sweatpants to the patient's last appointment.

Emergency contraception: just a hoax?

Emergency contraception is no more contraception than abortion. Now don't get me wrong: I am very pro-choice. But the emergency contraceptive pill implies to misguided people that they don't have to take responsibility for sexual activity until after the fact.

Gaps in pregnancy diabetes testing

Gestational diabetes mellitus (GDM) is a serious health condition that occurs in 4% to 12% of pregnancies, but recent research showing significant screening gaps for the disease makes the problem an even greater concern.

Health courts: courting tort reform

As a health-care provider I can't think of a more pressing problem than that of tort reform. This issue is staring us in the face and demanding a collective swift, supportive action by the medical community.

GI side effects of pain medication

What are the side effects of fentanyl?

Are we truly evidence-based providers?

Many clinicians misuse the term evidence-based medicine. Something needs to be done to prevent these words (and this concept) from becoming another medical cliché.

Vaccine lawsuits promote public mistrust

NVIA, VAERS protect against liability, ensure public safety.

Music therapy in palliative care

The therapeutic use of music, particularly among those who are terminally ill, has tremendous benefits.

Talking through the mammogram furor

Clinicians need to better screen their patients and educate them about when best to begin obtaining routine mammograms.

The residency match and primary care

Will there be enough primary-care providers to treat the new patients covered under the Affordable Care Act?

Patients deserve to hear tough news

Research shows that most Americans would want to know if they were severely ill and likely to die.

It's not the diet; it's the dietary pattern

If you lose weight, does it matter how you lost the weight? Not really.

Polymedication: You can cut seniors' risk

A patient is at risk for one medication error per day, and about one-fourth of related injuries are preventable.

When a delusion is not a delusion

There has been a recent explosion in the diagnosis if delusions of parasitosis, in which patients mistakenly believe they have a skin infestation.

Why depression is hard to diagnose

Occupational, financial, and life events must be considered when trying to pinpoint the problem.

Dealing with the difficult patient

Do you have a patient who is impossible to communicate with? Our expert has some advice.

Experience is not the same as expertise

A study found that physicians who have been in practice longer may be at risk for providing lower-quality care.

Get online to keep up with flu issues

Numerous Internet resources can help clinicians stay current with influenza outbreaks and other infectious disease developments.

Don't let technology trump medicine

Have clinicians become too dependent on technology?

Medical homes: A feasible concept?

Minimize impact of violence for young people

HIV screening: Just another routine test?

Why is HIV testing so different from other types of routine screening?

Reducing pharmacy "telephone tag"

I thought it might be useful to share some quick ways you can improve the safety and efficiency of your prescriptions and reduce pharmacy callbacks.

How much should my patient exercise?

Tailoring exercise recommendations to meet the unique needs of each patient gives those patients a better chance of meeting the fitness goals they have set with you.

Noncompetes are nonproductive

Noncompete clauses harm our patients and the public.

A new model for CVD prevention

A multidisciplinary, nurse-coordinated, family-based program improved lifestyles and reduced cardiovascular disease (CVD) risk among patients and their families in hospital and general-practice settings

Get curious about CAM

You might be surprised to know that even if you're not utilizing complementary and alternative medicine (CAM) therapies, some of your patients probably are...

Raise vaccine rates in primary care

Are we providing recommended vaccines to our patients? The answer is no.

You can help alcohol misuse

With all of the pressures on primary-care clinicians to see more patients while improving the quality of care, we need help in prioritizing the preventive services we provide. Responding to this need, the U.S. Preventive Services Task Force (USPSTF) has identified the most effective preventive measures, and a careful review has prioritized them based on how they fulfill two important criteria: burden of disease prevented when each service is delivered regularly and the cost-effectiveness of doing so (Am J Prev Med. 2006;31:52-61).

MRSA: Not a new crisis

We can prevent many patient infections

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