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

I CANNOT believe it is mid November! Halloween flew by and holiday season is around the corner. I’m trying to prepare but at the same time, I just want to sit back and soak it all in. It always goes so fast and then suddenly it’s January. So here I am saying it aloud for accountability - I’m going to try to stay here in the moment. It’s a magical time of year, right? 😆 

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

In the News

In the past couple years, the adult immunization schedule has exploded in complexity. High dose flu shots, Shingrix, Prevnar 20, not to mention COVID and now RSV vaccines. Many patients are overwhelmed, confused and fatigued. Adding to the mess - many Medicare patients have to go to their pharmacies for some of these vaccines (but not all of them), and it’s unclear how much each jab will cost.

This article goes into detail explaining the complexities of payment, vaccine administration and schedules and how this ultimately affects vaccination rates. It’s a great reminder of the barriers are patients are facing while navigating preventive healthcare.

In Your Practice

I would love to hear more about how each of you handle complex patient portal messages. From a patient perspective, I understand how difficult it is to even get a doctor’s appointment, let alone have enough time to discuss the many questions that come up. The patient portal is an easy way for patients to talk directly to their doctor or APP. However, for us, this often results in lengthy complicated messages that are quickly overwhelming. How do you deal?!

• Do you turn them into telephone visits?

• Do you use E-visits?

• Do you ask the patient to schedule an appointment?

• Do you have your staff call the patient to schedule?

• Do you communicate through your staff or write the patient back directly?

Please share! You can just reply to this newsletter. I will then share tips and thoughts in a future newsletter.

In Your Heart

My thoughts are less medicine-related today, but here we go anyway. I love to read. As a kid, I would go to the library with my best friend. We would borrow stacks of books and spend our play date reading in different cozy corners of my childhood home. (This still sounds like a fantastic way to spend a day - if only!) Over the years, I’ve read a mix of genres - fiction, nonfiction, self-help, biographies, best-sellers.

Over the past few years, I’ve been reaching for lighter reads. More chick-lit, if you will. Even romance - GASP. My kindle purchases and library borrows are sometimes tinged with guilt. I am an intelligent woman who wants to continue to grow and learn - shouldn’t I be reading the newest bestseller about optimizing productivity? Or the newest political biography? I try, sometimes. I have a well-intentioned stack of non-fiction on my nightstand. Fast-forward to bedtime - my mind and body are exhausted, and after a couple pages, I’m usually swapping it out for the latest Katherine Center novel on my kindle. I suspect a combination of factors led to this including a desire for escapism amid the pandemic plus the exhaustion of early parenthood. Although these both have eased, I’ve held onto the joy that a good light read delivers.

Thus, I’ve decided that this is OK. I’m going to lean into my soft chick-lit. I like the positivity. I like the happy endings. It’s a great way to wind down my day and I’m owning it. Here’s to taking what we feel like we need - not what society or social media tells us we should be doing or reading or watching. You do you. 🙂 

If you’re interested, here are a few of my favorite authors and books bringing me joy lately:

Pineapple Street by Jenny Jackson

Happy Place by Emily Henry

American Royals by Katharine McGee

The Summer Place by Jennifer Weiner

The Bodyguard by Katherine Center

Please send any book recs my way!

Have a wonderful weekend!

Ashley