The Last Day of Normal

Posted on: April 6, 2020 | No Comments

by Sarah Cole, DO, FAAFP

The Last Day of Normal By:  Sarah Cole, DO, FAAFP On Saturday March 7th I flew from St. Louis to Chicago with friends.  I had spent the week preparing contingency plans for when SARS-CoV-2 trickled into my corner of the Midwest and was ready for a fun weekend.  My friends had casually wondered in the days preceding if we should still go, as there were rumors that the East and West coasts may start to restrict travel, and they …

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Paradigm Shift in Concussions Treatment

Posted on: March 12, 2020 | No Comments

by Brian Mahaffey, MD, FAAFP

Paradigm Shift in Concussions Treatment By:  Brian Mahaffey, MD, FAAFP Concussions are a hot topic in sports today. Our awareness of them, as a society, has increased exponentially in the past 10-15 years. This is driven by the press, an increase in research and awareness of outcomes, and a push by health care professionals to educate the public. Our ability to educate is key to driving improved outcomes for all our patients. …

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Point-Of-Care Ultrasound (POCUS) – Two Blogs for Family Physicians

Posted on: February 14, 2020 | No Comments

by Robert D. Arnce, M.D. FACEP and Todd Shaffer MD, MBA, FAAFP

Point-Of-Care Ultrasound (POCUS) Making Its Way to a Family Practice near You! Robert D. Arnce, M.D. FACEP Point-of-care ultrasound (POCUS) is the use of a portable ultrasound at the patient’s bedside by the clinician to answer specific clinical questions and aid in the performance of procedures. As a practicing ER physician, I have used POCUS in my practice since the mid-1990’s. I find POCUS helpful both as a diagnostic and p …

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Acupuncture – Let Pain Be the Guide for the Needle

Posted on: January 10, 2020 | No Comments

by Jennifer Powell, MD

Acupuncture – Let Pain Be the Guide for the Needle Acupuncture is a versatile tool well-suited for the family physician. Its uses and benefits are many. Learn more about acupuncture and its role in family medicine. In 2017, I took an eight-month course in acupuncture. The course is specifically designed for allopathic physicians who know little to nothing about Traditional Chinese Medicine (TCM). It jams basic knowledge of TCM …

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Find Your Family Medicine Niche

Posted on: December 12, 2019 | No Comments

by Kara Mayes, MD

Find Your Family Medicine Niche Kara Mayes, MD In 2013, in the middle of a fairly typical day of seeing patients in the office, I had a patient who  asked me about a medicine called Qsymia, used for treatment of obesity. She had a friend who had been losing weight successfully with the help of this medication and wondered if it would be appropriate for her. As I was only a year out of residency, this patient got one of my freq …

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Improving Adherence for Patients with Diabetes

Posted on: November 15, 2019 | No Comments

by Jeff Unger, MD, FAAFP, FACE

Diabetes is a chronic progressive disorder which results in death from cardiovascular disease in 80 % of impaired glucose tolerant patients. Epidemiologic studies published by Paul, et al (Paul S et al. Cardiovasc Diabetol. 2015;14:100 doi:10.1186/s12933-015-0260-x) suggest that reducing baseline A1C to < 7.5 % within 2 years of one’s diagnosis can reduce the incidence of CV mortality by 61 %. Primary Care, which currently …

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PDMP Participation

Posted on: October 15, 2019 | No Comments

by Emily Doucette, MD, MSPH, FAAFP; Tara Robinson, MA; and Emily Varner, MPH

The St. Louis County Prescription Drug Monitoring Program (PDMP) launched in April 2017 as a clinical care tool to improve controlled-substance prescribing and inform clinical practice. The St. Louis County PDMP monitors the prescribing and dispensing of schedule II-IV controlled substances and allows doctors and pharmacists to review a patient’s controlled substance prescription history to assist in identification and prevent …

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Centering Pregnancy

Posted on: September 16, 2019 | No Comments

by Natalie Long, MD

Group prenatal care is a prenatal model that brings together groups of women who are roughly the same gestation age for prenatal checkups, interactive learning, and social support. This alternative model to traditional prenatal care was designed to improve patient education and include opportunities for social support while still continuing routine prenatal health assessments. Group prenatal care allows for more educational op …

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Don’t Gamble With ACE’s

Posted on: August 15, 2019 | No Comments

by Kyle John, MD

According to the CDC, Adverse Childhood Experiences (ACEs) is the term used to describe all types of abuse, neglect, and other potentially traumatic experiences that occur to children and adolescents. The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study is an investigation of childhood abuse and neglect and household challenges and later-life health and well-being. The original ACE Study was conducted at Kaiser …

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Skin Cancer Does Not Discriminate

Posted on: July 16, 2019 | No Comments

by Helen Tergin, MD

The focus of the summer issue of the Missouri Family Physician is Dermatology. Dermatology is such an intricate topic, and a very important one at that; especially now in these warm summer months where a lot of us are exposed to the sun’s harmful UV rays. In the next issue of the magazine which comes out later this month, you will find articles covering symptoms and types of skin conditions, skin care tips, dermatologic emerge …

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On the Road with MAFP President, Dr. Sarah Cole:

Back on the Trail: Meeting the Future of Family Medicine

Posted on: November 13, 2019

Back on the Trail: Meeting the Future of Family Medicine Last year I “traveled the trail” with MAFP, visiting practicing family physicians in all ten MAFP geographic districts, learning about their day-to-day joys and woes as they care for Missourians in the diverse ways family docs do. As I prepared to summarize my findings to MAFP and it’s Board of Directors, however, I realized there was an entire population of Missouri’s f …

Valuing individual members of the patient care team: District 10

Posted on: May 15, 2019

To round out my perspective on District 10 (and close out my district visits for the year!), I look forward to meeting individually with District 10 Board delegate Dr. Vicki Roberts at the MAFP Show Me Family Medicine Conference come June.  If you’ve not yet registered for this conference, be sure to do so at for a great educational and networking opportunity in Lak …

Pollen, passion and paperwork: Districts 8 and 9

Posted on: April 25, 2019

My car and I were both messy as I visited Districts 8 and 9, it’s body thickly covered in the green pollen that settles upon Missouri in mid-April and my own clothing smeared with streaks of it as well.  I was nonetheless welcomed by staff and physicians of three clinics across both districts.   The day was rich in discussion, so much so that I took 10 pages of notes!  This month’s blog is a bit longer as it covers two distric …

Spring in northeastern Missouri: expanding communication across our state

Posted on: April 1, 2019

I was chauffeured this month by my 15-year-old daughter on my visit to District 2.  The hills roll more gently in the northern half of our state than the southern and so we took advantage of the geography to enjoy (well, she enjoyed while I nervously endured!) some practice driving on her permit.  It was early spring and so, though the temperature peaked at seventy degrees, we passed fields still stippled with the remnants of …

Reforming rather than bypassing residency training in Missouri

Posted on: February 25, 2019

District 6 Revisited: Reforming rather than bypassing residency training in Missouri Of the 101 rural counties in MO, 99 are primary care shortage areas.  Vernon County is one of those 99.  On Valentine’s Day, Executive Director Kathy Pabst and I spent time in Vernon’s county seat of Nevada with Dr. Jennifer Conley, her partner Dr. Heather Russell, her assistant physicians Dr. Caitlin Elmore and Dr. Kristle Miles and staff of …

January District 4 Blog

Posted on: January 30, 2019

District 4: Winter in Washington: Advocacy and Artificial Intelligence for EHRs In January, Executive Director Kathy Pabst and I met with Drs. Jennifer Scheer and Keith Ratcliff at the Old Dutch Tavern in downtown Washington, MO.  Drs. Scheer and Ratcliff are both delegates to MAFP’s Board of Directors and both practice in towns of 2000 people or less near Washington.  To meet them, I drove through the wispy fog on moonlit sta …

Family Physicians as Unapologetic Leaders

Posted on: January 30, 2019

In addition to meeting this month with delegates from District 4, I have been honored to attend, on behalf of the MAFP Board of Directors, two events for related professional organizations. The St. Louis Academy of Family Physicians installed it’s 2019 officers and Board of Directors over dinner in a local restaurant on 1/6/19.  The Missouri Society of the American College of Osteopathic Family Physicians installed it’s 2019 o …

Home for the Holidays

Posted on: December 6, 2018

As I continue my trek across Missouri this year, I stayed ‘home for the holidays’ by visiting my own District 3 when Kanika Turner, MD, MPH, former resident delegate to the MAFP Board of Directors, accepted my invitation to meet over lunch.  I listened to holiday music as I made the shortest drive of these journeys thus far to south St. Louis City to meet Dr. Turner near Family Care Health Center, the federally qualified healt …

Family Medicine Outside Missouri

Posted on: November 4, 2018

Instead of visiting MAFP members in their home districts this month, I ventured outside Missouri, all the way to The Big Speakeasy, the birthplace of jazz, the Crescent City, for my first visit to New Orleans, LA as I accompanied MAFP delegates Keith Ratcliff, MD (District 4), Todd Shaffer, MD (District 7), Peter Koopman, MD (District 5) and Kate Lichtenberg, DO (District 3) to AAFP’s annual Congress of Delegates. Above and be …

On the Road Again

Posted on: October 15, 2018

As I drove toward MAFP District 6 in west central Missouri, I passed highway miles by listening to the AFP Podcast bonus episode from September 17, featuring an interview with Dr. Margot Savoy, Chair of the Department of Family and Community Medicine at Temple University Lewis Katz School of Medicine. During her interview, Dr. Savoy reminded medical students applying to residency that Family Medicine is not a back-up plan. If …