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

It’s the first official weekend of summer! I think we will be kicking it off with pool time and a cook out if the weather cooperates.

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

In the News

“Should I take a baby aspirin?” It’s a question I hear often. The guidelines for primary prevention of atherosclerotic cardiovascular disease using low dose aspirin have been refined over the past couple years (you can read more here) to be more rigid, but it is still a widely used medication. For all the good it can do, low dose aspirin is obviously not without risk, especially of major bleeding.

This study from The Annals of Internal Medicine, published just this week, found a 20% higher risk of incidental anemia and low iron levels in older adults taking low dose aspirin for 5 years vs older adults taking a placebo. This was a randomized controlled trial of about 20,000 otherwise healthy adults.

The takeaway? Consider regular monitoring of hemoglobin levels in older adults on baby aspirin.

In Your Practice

In the last edition, I shared tips from the Harvard conference on how to prep for an office visit to make your day easier. (You can see my last post here, if you missed it!) Now I’ll share strategies used AFTER the office visit to help speed your day along. Obviously, again this is not a one-size-fits-all. We all work differently!

• When writing notes, keep the plan portion simple and short - 1 line for each problem if possible.

• schedule virtual follow up visits to discuss lab results, especially when complex. This limits back and forth on the phone and via MyChart.

• At a minimum, document physical exam findings, place orders and do refills before moving to the next patient.

• Use dictation.

• Type the HPI while in the room with the patient.

• Dictate the assessment and plan while in the room with the patient.

• Write notes and chart while the information is fresh - it takes much longer after the fact.

• Don't skip lunch!

• Skip lunch. (Haha).

In Your Heart

Have a wonderful weekend,

Ashley