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

Changes abound at my office lately. A colleague just retired (we miss you dearly already, Kathy!) and my other colleague welcomed his newborn son just several weeks ago. Much to celebrate! It’s great to connect with coworkers over things that simply aren’t work related. Life transitions, new babies - all heart-warming 🙂 

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

In the News

With cold season upon us, OTC medications will be top of mind for many of our patients. In mid September, the FDA advisory panel announced a unanimous vote declaring the oral form of phenylephrine ineffective as a nasal decongestant based on this slew of evidence. The FDA will next decide if they will revoke the drug’s OTC status which would require it to be removed from shelves.

In Your Practice

As primary care physicians and providers, we are expected to address and treat most body systems in at least some capacity. We need to know “a little about a lot”. In reality, we need to know “a lot about a lot”.

Our patients often come to use with multiple concerns and questions, from head to toe, simple to complex. As their physician, it’s my job to help direct and guide the visit. When I first started practicing, this was overwhelming. How could I even begin to address the list of concerns in my patient’s notebook when I had my own list of preventative health tasks and chronic disease questions to get through?

With experience, I’ve found it’s best to acknowledge this in the room. I usually start by having the patient share what they want to discuss today. This helps me know ahead of time what is most important and prevents me from being surprised at the end of the visit. If it’s a lengthy list, I will often help them narrow it down to their top 3 concerns. I explain that we will address all of their questions over the next couple visits but that I want to give sufficient time to each topic in order to provide accurate and thorough care. I sometimes even say the phrase, “I know these first visits can seem like a lot, but we will move forward one step at a time over the next few visits together to get you feeling better”.

This helps set the expectation that it can take multiple visits to solve a problem and move forward in a treatment plan.

In Your Heart

The healthcare system is notoriously difficult to navigate, especially from a patient’s perspective. However, I had an experience last week that pushed back on this notion and demonstrated how teamwork can really make a difference.

I have a lovely patient who was visiting family out of state when she ended up in a rural emergency room unexpectedly. Her CT scan demonstrated a new lung mass. She traveled back to Ohio and turned to my office to guide her in the next steps. I quickly reached out to a pulmonologist colleague. She replied back immediately and helped direct me to the specialist who could perform the necessary procedure. He returned my call within 10 minutes, already having seen the scans and helped schedule the patient for her bronchoscopy within 24 hours.

By the time my patient showed up for her appointment with me, we had a multi-specialty plan in place to help her get the answers she needed quickly and efficiently. I finished that day feeling grateful for my colleagues and their quick actions and attention. We all came together to help our patient in a time of urgent need. This is what it’s all about.

Have a wonderful weekend!

Ashley