Air Quality, CME, and the Power of Comfort

Author

Ashley Chambers
June 09, 2023

Hello! Welcome back to The Friday Sign Out - a newsletter for primary care physicians and advanced practice providers.

Happy Friday! June feels like it is already flying by. Here we go headlong into summer. I’m loving the long daylight hours, hot dogs on the grill on a Tuesday, after work picnics, and exhausted sun-kissed kiddos. Trying to soak up every minute of it!

Here’s what I’m reading and thinking about this week.

In the News

As an Ohio native, wildfires are not usually top of mind - until this week. The Northeast and parts of the midwest are seeing dangerous levels of smoke and terrible air quality. This is concerning on many fronts, but especially for our at-risk patients (those with lung disease, etc).

The link below is from Your Local Epidemiologist, a great newsletter about all things epidemiology, infectious disease, and public health. This is a quick read, but she does cite a study looking at the effects of smoke inhalation on firefighters and discusses ways people can reduce exposure. Great info for patients, too.

Well, it's wildfire season...

It’s officially wildfire season. Climate change has made wildfires more frequent and intense. We certainly don’t need to inform people in Canada and the Northeast, as they can just look outside and see dangerous levels of smoke. Wildfire smoke contains tiny particles

open.substack.com/pub/yourlocalepidemiologist/p/well-its-wildfire-season?r=zecyl&utm_campaign=post&utm_medium=email

Here is another article with additional info about masks and filters:

How the public health lessons of Covid can help Americans protect themselves from wildfire smoke

Here are just a few ways in which the public health lessons of Covid may now help people to minimize health risks from air pollution.

www.statnews.com/2023/06/07/air-quality-canadian-wildfires-protection/?utm_campaign=morning_rounds&utm_medium=email&_hsmi=261585256&_hsenc=p2ANqtz-9zd8Re1zLddKxwZrVA5oXiWjwBMQ83h5O4BzDj5mn986u8SesDQYOTRMezRenxfJ1ij_gsfLJsrPP-kP0dSQIXZLw7pA&utm_content=261585256&utm_source=hs_email

In Your Practice

For the past 3 years (since the pandemic), I’ve attended a Harvard virtual CME course, “The Office Practice of Primary Care”. It’s a fantastic conference - so much great information. A session from the latest course focused on optimizing the workflow in primary care. They polled the audience of about 350 people, asking “What strategies do you use before an office visit to make your day easier?” There were 13 pages of responses! Here are a few of the highlights:

  • Pre-chart 5-15 minutes based on the visit type, spend 1 minute reviewing social history.

  • Review the last note, recent hospital visits, and labs right before going in the room.

  • Huddle with the MA prior to the start of the day to review the schedule.

  • Right before each visit, pre-populate the note using templates and pend labs and orders.

Most of the tips centered around pre-charting in various capacities. I know some physicians spend significant time pre-charting, while others not so much. It’s not one-size fits all!

Here’s a link to the 2024 conference if anyone is interested.

Office Practice of Primary Care Medicine

Harvard CME: The Comprehensive Update on Office-Based Primary Care Medicine

primarycare.hmscme.com

In the next issue, I’ll share the top strategies for AFTER office visits. Stay tuned!

In Your Heart

I love this quote which really hits home on our role as PCPs. Much of our job revolves around listening, reassuring, supporting and communicating. Dr. Trudeau famously treated patients in the late 19th century at the tuberculosis sanitarium in New York, before the invention of anti-TB drugs. Here he speaks about the role of physicians, knowing a cure isn’t always possible.

“To cure sometimes, to relieve often, to comfort always.”

Edward Livingston Trudeau

Have a wonderful weekend!

Ashley