Category Archives: Family Medicine

Family Medicine

Growing Readers program expanding – The Republic

In partnership with local pediatric care providers, the Bartholomew County Public Library and Viewpoint Books are expanding the Growing Readers program to increase access to early literacy resources throughout the community.

The Growing Readers program began last year with the aim of encouraging children to read 1,000 books before kindergarten, but it is growing to meet evolving needs within the community, according to organizers. Thanks to grants from both the Heritage Fund the Community Foundation of Bartholomew County, and the Mildred A. Reeves Early Education Fund, the program will now extend beyond the initial scope and increase impact by:

Research has shown that when it comes to early literacy development, it is not the just quantity of words a child hears from their caregivers or the number of books they read together, but the quality of the interactions between them that matters most.

Organizers said the expanded program, with its emphasis on providing both reading materials and caregiver education, seeks to empower families to be involved in their childrens early literacy development in ways that are both meaningful and effective.

After extensive research and discussions with local pediatric care providers, it became clear that the most effective means of reaching children and their caregivers would be at scheduled well-medical visits. With roughly 95 percent of children living in Bartholomew County attending their scheduled well visits, this partnership program will provide the tools and information families need by reaching them in a place they are already visiting regularly.

During the initial pilot period, families with children between 6 months and 5 years old at Northside Pediatrics and Sandcrest Family Medicine will receive quality books, early literacy tips, and support information suited to their childs age and development.

Organizers said that eventually, the program hopes to work with all of the pediatric care providers in the county and in doing so to reach all children in the community.

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Growing Readers program expanding - The Republic

Family Medicine

AAFP President: We Need to Go Forward, Not Backward, on Racial … – Patient Care Online

"As a family physician one finding that particularly stood out to me is that adults of color were more likely than white adults to report not having a usual doctor or provider and to have to go without care because of the cost."

American Academy of Family Physicians president Tochi Iroku-Malize, MD, MPH, MBA, referred to findings from the recent Kaiser Family Foundation update to its data on health and health care in the US by race and ethnicity. The update revealed that approximately one-third of Hispanic adults, one-quarter of American Indian Alaskan Native adults, and 1 in 5 Black and Asian adults do not have a personal health care provider vs 16% of White adults.

Among other grave concerns about the findings, Iroku-Malize framed data on US maternal and infant mortality among racial and ethnic minorities as moving backward in the 21st century, not forward. More of her conversation with Patient Care follows.

Tochi Iroku-Malize, MD, MPH, a family physician in Long Island, New York, is current president of the American Academy of Family Physicians. Iroku-Malize serves as founding chair and professor of family medicine for the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York, and is senior vice president and chair of the family medicine service line for Northwell Health. She oversees 4 family medicine residency programs and 3 fellowships spread across 23 hospitals. She was previously the director of the family medicine residency program at Southside Hospital in Bay Shore, New York. She is currently a member of the Society of Teachers of Family Medicine and is active in the Association of Departments of Family Medicine.

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AAFP President: We Need to Go Forward, Not Backward, on Racial ... - Patient Care Online

Family Medicine

Tobacco assessments decline in primary care – Healio

March 30, 2023

2 min read

Disclosures: Flocke and colleagues report no relevant financial disclosures.

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The monthly rates of tobacco assessments in primary care decreased by half during the early months of the COVID-19 pandemic and remained low despite transitions back to in-person care, according to a recent study.

Since the start of the pandemic, several studies have shown a decline in receipt of preventive care and chronic disease management, Susan A. Flocke, PhD, a professor in the department of family medicine at Oregon Health & Science University, and colleagues wrote in Annals of Family Medicine. Little is known about the impact of the pandemic on addressing tobacco use. Given the relevance of tobacco use for severe symptoms of COVID-19, it is important to understand the pandemics impact on tobacco assessment and cessation assistance.

Furthermore, diminishing the harms of smoking is particularly important in the context of community health centers (CHCs) which provide primary care services for a large proportion of socioeconomically disadvantaged patients, the researchers wrote.

To evaluate changes in tobacco assessments and cessation assistance, Flocke and colleagues analyzed electronic health record data from 217 CHCs across 13 states. The analysis included 759,138 in-person and telehealth visits that occurred from Jan. 1, 2019, to July 31, 2021.

Tobacco assessment rates declined from 155.7 per 1,000 patients in January 2019 to February 2020 to 77.7 per 1,000 patients in March 2020 to May 2020, equaling a 50% decrease. Although rates rose from June 2020 to May 2021, they remained 33.5% below pre-pandemic levels, according to Flocke and colleagues.

Provisions of tobacco cessation counseling also decreased, although to a lesser extent, from 109.5 per 1,000 tobacco users in January 2019 to February 2020 to 87.1 per 1,000 tobacco users in March 2020 to May 2020. Like tobacco assessments, provisions increased to 107.9 per 1,000 tobacco users from June 2020 to May 2021, though were still 2.5% lower than pre-pandemic levels.

Provision of tobacco cessation medications was low, 43.9 per 1,000 tobacco users from January 2019 to February 2020, and declined slightly across the time periods, the researchers wrote.

Flocke and colleagues noted it is possible that tobacco assessments were interrupted during the transition to telehealth and never reestablished when care returned to the physical clinical setting.

Tobacco assessment before the pandemic was likely conducted by medical assistants during the rooming process involving vital signs and tobacco use history, they wrote. It is likely that telehealth visits changed this workflow such that gathering vital signs typically done by the person who roomed the patient was omitted as a step before initiating the interaction between the patient and clinician.

Additionally, though telehealth services could be effective in assessing patients tobacco history and potential treatments, lack of standard workflow on when and who should assess tobacco history during telehealth visits in CHCs could have impeded tobacco assessment performance, the researchers wrote.

They concluded that due to the health consequence of tobacco use, all primary care settings should have a process in place to routinely assess tobacco status and to provide assistance for quitting.

Careful examination of procedural changes that promote or impede assessment of tobacco, including adaptation to support tobacco assessment via telehealth, is needed to guide resilient procedures that can weather operational changes, they wrote.

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Family Medicine

Why Hundreds of Wisconsin Doctors Are Asking You to Vote in Next … – UpNorthNews

More than 300 Wisconsin physicians and healthcare professionals announced their joint endorsement of Milwaukee County Judge Janet Protasiewicz in next weeks state Supreme Court electionanother example of how people who hadnt been politically involved previously were spurred to action by right-wing moves like the elimination of a national right to abortion care for women.

This is an issue that affects the entire house of medicine, said Dr. Kristin Lyerly, an obstetrician-gynecologist from Green Bay. This isnt just the Ob-Gyns who are worried about it, but its the emergency medicine docs, family medicine docs, residents, medical students, people who have dedicated our lives to take care of our patients. We recognize that this is interference in the doctor-patient relationship, and that means that we cant take the best possible care of our patients and in some cases we cant take care of our patients at all.

The physicians endorsement was published as a full-page ad in Tuesdays Milwaukee Journal Sentinel and touted at an online news conference organized by the Committee to Protect Health Care.

As [conservative former Justice] Daniel Kelly tries to downplay his extremist views against abortion, medical professionals are raising the alarm and bringing awareness to the consequences of this election for Wisconsin women, Dr. Madelaine Tully, a family physician in Milwaukee County, said in the press event. Mr. Kelly has been endorsed by multiple anti-abortion organizations, including one which supports banning abortion with no exceptions even for the womans life. Mr. Kellys track record goes against medical principles and the beliefs of most Wisconsinites.

Doctors are typically not political, Lyerly said Wednesday morning on UpNorthNews Radio. But we came together from across the state, across specialties, to put our foot down and say this has got to change.

With this [newspaper] advertisement and our advocacy, medical professionals want to make loud and clear that Wisconsinites should stand up for reproductive freedom and health by electing Judge Janet Protasiewicz, said Dr. Jill Cousino, an OB/GYN in southern Wisconsin and member of the Committee to Protect Health Care (CTP). With an election likely to have enormous consequences for abortion access, medical professionals are speaking out in support of our patients and all Wisconsin women. Like Judge Protasiewicz, we believe in a womans freedom to make her own decisions around her body and her health care, and the majority of Wisconsinites who agree should keep this in mind when voting next Tuesday.

The physicians noted they are speaking out in their own capacity and not on behalf of any of their employers.

Protasiewicz has repeatedly said she is 100 percent certain that if Kelly is elected, the states 1849 abortion ban will stay on the books. Kelly has been endorsed by Wisconsin Right to Life, Pro-Life Wisconsin, and Wisconsin Family Action.

Last week, Kelly appeared at a St. Croix County event that featured Brookfield pastor Matthew Trewhella, who has compared COVID-19 safeguards to the Holocaust and predicted violence would be the result of government mandates. A story from the Milwaukee Journal Sentinel about the event mentions a 1994 Newsweek report that said Trewhella was one of six anti-abortion activists under investigation as possible conspirators in a campaign of violence against abortion clinics and that Trewhella signed a statement declaring that if an abortion provider was murdered by an anti-abortion activist, the assailants legal force was justified.

Tuesdays election is to fill a seat opening with the retirement of conservative Justice Pat Roggensack. A Kelly victory will allow conservatives to maintain a 4-3 majority while a Protasiewicz win would give progressives control of the court for the first time in 15 years.

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Why Hundreds of Wisconsin Doctors Are Asking You to Vote in Next ... - UpNorthNews

Family Medicine

Fact Or Fiction: 10 Common Beliefs About Sun Damage & Skin Health – Study Finds

Skin cancer is the most common cancer in the United States. According to the American Academy of Dermatology, the condition affects more than 3 million people annually. About 99 percent of the cases are caused by damage from the ultraviolet rays of the sun. Skin cancer is virtually 100 percent preventable, because you control your sun exposure.

One in five Americans will develop skin cancer by age 70. Non-melanoma skin cancer, however, is often excluded from cancer statistics, and is not reported in global statistics because it is so very common and under-diagnosed. It is also frequently managed within primary care (e.g., family medicine) without being reported, according to the World Cancer Research Fund International. Melanoma cases are rapidly rising across the U.S., however, and this very dangerous type of skin cancer on its own is expected to become the second most common cancer in the coming years.

Test your knowledge about sun damage and learn how to minimize your risk of developing skin cancer.Do you thinkthe commonbeliefs about sun damage and skin health listed below are fact or fiction?

Fiction: A study conducted by the United States Food and Drug Administration (FDA) determined thatless than 25 percent of sun damage occurs before the age of 18. After that, 10 percent more accrues for every decade of life. However, one blistering sunburn before the age of 18 can double your chance of developing melanoma. The 80 percent figure was based on incorrect information and miscalculations.

Intervention at any age is beneficial for starting protection and repairing some damage. A broad-spectrum sunscreen (covers both UVA and UVB rays) with a sun protection factor (SPF) of 30 should be used daily on your face and any other exposed areas of skin. Limit getting direct sun exposure, and use barrier antioxidant products (e.g., zinc oxide.) Heres a list of the best sunscreens, according to experts.

Fact: You can burn in the shade, from UV radiation reflected off nearby surfaces. According to the World Health Organization (WHO), surfaces youd never suspect of reflecting UV rays canincrease your risk of burning. Sea foam reflects 25 percent of UV radiation and sand reflects 15 percent. Grass, soil, and water reflect less than 10 percent. Fresh snow doubles your UV exposure. Take care when outdoors to protect yourself from burning.And by the way, its important to use sunscreen for your pets too.

Fiction: The bronzing of the skin with tanning is the result of DNA damage. UV light damages skin cell DNA and the body tries to repair the damage. The process produces melanin, which darkens the skin.

Fiction: You can get a more serious sunburn on cloudy days than in direct sunlight. According to the World Health Organization, 80 percent of the suns ultraviolet rays pass through a light cloud cover. Theres also an interesting phenomenon called the broken-cloud effect.

Partly cloudy days can intensify surface UV radiation by 25 percent and make the UV rays associated with skin damage 40 percent greater. Scientists speculate that the effect may occur when UV rays are reflected off the sides of dense clouds or are redirected when passing through thin clouds.

Fiction: Naturally dark skin can burn and suffer the damage that is associated with developing skin cancer. A study conducted by the American Academy of Dermatology revealed that African Americans are the most likely to die from melanoma, because they are least likely to be diagnosed early in the course of the disease. There is some protection associated with a naturally elevated level of melanin, but some sun damage is still occurring.

Dr. Erin Boh, chair and professor of dermatology at Tulane University School of Medicine, tells The Healthy: Remember that children can get sunburned despite their skin color. I advise all patients to use at least an SPF 30 sunscreen or a physical barrier such as zinc or titanium oxide.

Fact: You can have a sunburn long before your skin becomes visibly pink, says Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City. In fact, the first sign you may be getting a sunburn is that your skin will start to itch and feel hot, in an interview with The Healthy. Other signs include thirst, skin tightness, and pain with touch. The skin may turn white when you apply pressure to it.

Fact: According to the American Academy of Dermatology, a single session in a tanning bed can increase your risk of melanoma by 20 percent, squamous cell carcinoma by 67 percent, and basal cell carcinoma by 29 percent. Women younger than 30 are six times more likely to develop melanoma by using tanning beds.Some states prohibit their use by children.Heres a list of thebest self-tanning lotions for individuals who want to avoid the harms from using tanning beds.

Fact: Strawberriescontain vitamin C and tannins, which are beneficial for sun protection, and tomatoes contain lycopene, which is known to protect the skin from UV damage, Dr. Green adds. But while eating them may offer some natural sun protection, it shouldnt be a reason to skip the sunscreen.

Bonus knowledge: Prior research also shows that eating grapes can protect you from sunburn. Adding them to your fruit salad alongside strawberries and tomatoes can give you a nice edible sunscreen, scientists say.

Fiction: Clothing yields an SPF of 4 to 8, with darker colors and tighter weaves of fabric being more protective, according to the Skin Cancer Foundation.

What aboutso-called sun-protective clothing?UPF (ultraviolet protection factor) clothing and hats provide more protection and block more UV radiation than do untreated clothes. The protection decreases with repeated washes. Rit Sun Guardis a powdered product which can be washed into clothing to provide UV protection. It increases the UPF of the clothing to 30 and lasts for up to 20 washes.

Fact: You cant make a sunburn heal faster, but you can get some relief from the symptoms.

If you catch a sunburn earlyas soon as you feel the tingleyou can slow it down and reduce the severity with a non-steroidal anti-inflammatory drug like Aleve or Advil, says Dr.Christopher Huerter, associate professor of medicine and chief of dermatology at Creighton University School of Medicine in Omaha, in an interview with The Healthy. Cold compresses and aloe can also be helpful. You should see a doctor if you get a fever and chills. In that case, says Dr. Huerter, we would give [patients] a dose of oral corticosteroid, like prednisone.

As always, if you are concerned about your skin health, dont hesitate to reach out to your doctor with your questions.

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Fact Or Fiction: 10 Common Beliefs About Sun Damage & Skin Health - Study Finds

Family Medicine

Valor Health discontinuing labor and delivery – Idaho News

EMMETT, Idaho

Valor Health joins a growing number of hospitals in Idaho that will cease to provide Labor and Delivery services.

Valor health released a statement announcing a major transition in its obstetrics program, shifting resources away from inpatient labor and delivery to enhanced outpatient prenatal and postnatal care within the hospitals family medicine clinic.

The decision comes after a historically low delivery rate predicted for this year, fewer than 50 babies, and an ongoing shortage of qualified staff to work in the demanding field.

Brad Turpen, CEO of Valor Health, says the decision to stop providing labor and delivery services will take effect June 1, 2023. Turpen recommended Valor Health stop providing labor and delivery services and the Board of Trustees voted to support the recommendation. Valor Health is beginning efforts to transition existing patients in the lead up to June 1.

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Valor Health discontinuing labor and delivery - Idaho News

Family Medicine

Black pregnant people are twice as likely to die in childbirth. How … – MPR News

CATHY WURZER: The first part of the show is kind of focused on health and well-being. New data from the CDC out this month shows that the rate of folks dying in pregnancy or childbirth has risen considerably in recent years. There was a 40% increase in maternal deaths between 2020 and 2021, and that rate was more than twice as high for Black women whose maternal mortality rate was 70 deaths for every 100,000 live births.

What gives with that? We have Dr. Jay-Sheree Allen on the line from the Mayo Clinic. She's going to talk about why pregnancy and birth is still so very unsafe for some women in the US. Dr. Jay, welcome back.

JAY-SHEREE ALLEN: Thank you so much for having me again, Cathy. It's great to be here.

CATHY WURZER: Well, this is serious, serious stuff here. I mean, you look at the figures from the CDC. Maternal death is 10 times likelier in the US than it is in countries like Australia. You wouldn't think that to be true, but it is. What's going on?

JAY-SHEREE ALLEN: This is a tough one. This is a really hard one. Many of the things I talk to you about-- I'm the physician telling you kind of that perspective. But having had complications after my pregnancy, I felt like this article hit a little close to home for me. It's multifactorial, Cathy.

It's not any one answer, right? So we have to think of things like increased rates of chronic illness in our OB population, so rates of obesity, diabetes, heart disease in women who are giving birth-- in our country, prenatal care and inadequate prenatal care. I think it was the March of Dimes put out some statistics that said there are 6.9 million women in this country of childbearing age with no access or little access to care.

That all matters. Cost-related issues when it comes to care-- and we have to think too about missed or even delayed opportunities for treatment. We've heard the stories from Beyonce and from Serena Williams. I mean, some of the most well resourced women in this country still experiencing complications. And of course, I'd be remiss, right, if we don't bring up some of the structural biases and racism that are kind of ingrained in our system.

CATHY WURZER: I'm wondering about the role that COVID may have played in this, too. Can we attribute some of this spike to the pandemic?

JAY-SHEREE ALLEN: Yes. So these more recent numbers-- so we've been on the rise for the past few years, but there's certainly been a larger increase. I think up to 25% of those new numbers reported in 2021 are being attributed to COVID. And it's not entirely clear why, but some of the things-- blood clots with this virus, rates of pre-eclampsia.

Even I've seen mentions of people delaying or forgoing visits or going to appointments when the virus was at its height, and we really didn't understand what was taking place.

CATHY WURZER: I'm wondering-- you lay out a really dire situation here. What are doctors doing to try to help pregnant women?

JAY-SHEREE ALLEN: We in the medical community are aware that this is a major problem, and we've certainly been working on this on the back end. I think, though, it's multilayered. So with any institution, you see that there is training happening at this point, whether it's upstander training or there's more attention being placed on biases that we once had-- some women being able to tolerate pain than others, trusting or not believing.

I think the doctors are working on that. We do participate in continuing medical education courses to ensure that our knowledge base is at its height when we are caring for our vulnerable patients. But I think this goes beyond what an individual doctor or even just the health system is able to do. I think we need to take that 40,000 foot view and look a little bigger, right?

What are the policies like in this country that support or don't support the health and the well-being of women who are pregnant? Just getting granular for a second, Cathy. Think of just how common-- even the healthiest pregnancy with zero complications, you still have a certain number of appointments that you need to attend to see your midwife or to see your physician who's caring for you.

What are our jobs like in terms of giving us time off for these very much expected appointments, right? What sort of schedule templates are built in to allow us to not have to use PTO, which most women are trying to save so they can spend more time with the child after they are born considering our laws in the postpartum period? So it's really complex and beyond just the doctor.

CATHY WURZER: Wow. So I wonder, getting back toward the beginning part of our conversation about the public health aspects of this, do we also, do you think, need to have more education for women to be healthier going into a pregnancy? You mentioned diabetes, obesity, heart disease-- work on those public health issues as well?

JAY-SHEREE ALLEN: I think yes. I think yes, but I am not one of the "fix the woman" sort of-- I think we need to take that bigger, that larger view so we're addressing all of the different areas we can and not just victim blaming. But I think there's definitely room for improving our lifestyles or healthier lifestyles as much as we possibly can.

And again, recognizing that this is within the confines of the society in which we live, right? I heard someone say that the social determinants of health is the fishbowl we all swim in. It's the water we're all in, right? So you can be motivated to change some of those things, but your environment has a lot to do with this.

And then another important thing to recognize in this data that came out from the CDC-- the rates of maternal mortality also increased with age. And so older women, women over the age of 40 in particular, had higher rates than younger women under the age of 25. So I think that's also worth mentioning.

CATHY WURZER: Does that come as a surprise to you?

JAY-SHEREE ALLEN: No, it doesn't. It doesn't. And even now, a lot of us-- and I say us, myself included-- are delaying childbirth for many different reasons, in pursuit of our professional goals or working around our careers, and again, trying to fit within the standards in the confines of the society that we live in.

CATHY WURZER: There's a lot to unpack here. Always a pleasure talking to you, though, Doctor. I appreciate this. Thank you so much.

JAY-SHEREE ALLEN: You're so welcome. Thanks for having me.

CATHY WURZER: Dr. Jay-Sheree Allen. She's a family medicine physician at Mayo Clinic, also the host of the podcast Millennial Health. Get it wherever you ever get your pods.

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Black pregnant people are twice as likely to die in childbirth. How ... - MPR News

Family Medicine

Massachusetts Family Doctor Had Hidden Cameras, Thousands of Child Sex Abuse Images, Feds Say – NBC Connecticut

A Massachusetts family doctor was arrested for allegedly recording and possessing child sex abuse images, including on a hidden camera designed to look like a bracelet, prosecutors said Tuesday.

Dr. Bradford Ferrick, 32, was arrested Tuesday morning on a charge of possessing child pornography and was due to appear virtually in federal court in Boston, according to the U.S. Attorney's Office for Massachusetts.

About 80 devices were seized from Ferrick's homes in Winchester and Amherst, including hidden camera systems, last month, and thousands of images and videos showing suspected sexual images of children, prosecutors said. Alleged victims appear to be between 6 and 11.

"I can think of no greater fear as a parent or guardian than potential harm coming to your child. Today we allege that this doctor, who held a position of trust with access to children, maintained child sexual abuse material," U.S. Attorney Rachael Rollins said in a statement, noting that the investigation is ongoing.

Ferrick is a family medicine resident at Baystate Franklin Family Medicine, according to prosecutors. A hospital website listed him as a current resident at the hospital system's Greenfield Family Medicine.

NBC10 Boston has reached out to Baystate Health for comment. It wasn't immediately clear if Ferrick had an attorney who could speak to his arrest.

In Massachusetts, Ferrick had rotations in Springfield, Deerfield and Greenfield, prosecutors said. Before joining the hospital system in July 2022, he worked attended State University of New York's Upstate Medical University in Syracuse.

Investigators have set up this FBI website for anyone with information or concerns about the case.

Police in Winchester first reviewed tips from a national clearinghouse for child sexual exploitation information in January, according to the complaint filed in federal court. Videos with suspected child pornography were uploaded to a Google Drive in November 2021 and March 2022, each done in an IP address traced to Syracuse.

Winchester and state police searched Ferrick's parents home in Winchester, where he lives as well, on Feb. 13, and seized 61 devices, including hidden camera systems, computers, cellphones and storage devices that, in total, were able to contain more than 100 terabytes of data, the complaint said. He was arrested on four counts of possessing child pornography and released two days later on $50,000 bail under conditions including house arrest.

Several more devices were seized from the house later that week, after Ferrick appeared to have remotely manipulated one of the phones that had already been taken, investigators said.

A review of the devices found graphic videos showing a man raping a child, including two instances where the child was unconscious, according to the complaint.

The day after the search of the Ferricks' home, Winchester police found a hidden camera in a bathroom at the home of relatives, where two young children live, the complaint said. A Winchester detective had gotten permission to conduct the search after visiting the house and informing them of the charges.

The next week, police searched a home in Amherst that Ferrick rented and found eight more devices, including the hidden camera that appeared designed as a bracelet, investigators said. Its memory card allegedly showed videos of Ferrick giving medical exams in August 2022 with another doctor, including a audio of Ferrick apparently examining a teenage boy's genitals while his mother was present.

"It does not appear the individuals in the room are aware they are being recorded during either exam," an FBI agent wrote in the complaint.

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Massachusetts Family Doctor Had Hidden Cameras, Thousands of Child Sex Abuse Images, Feds Say - NBC Connecticut

Family Medicine

Family doctor: NC politicians making health care landscape toxic – The Fayetteville Observer

Dr. Rebecca Kasper| The Fayetteville Observer

As a family medicine resident physician in the Triangle area, I originally came to train in North Carolina because the state has some of the best family medicine programs in the country. For five years now I have called this state home.

I am involved in my local faith community, I volunteer with my neighborhood association, and I am falling in love with the varied landscapes across this beautiful state. I had planned on staying and raising my family here.

However, the increasingly toxic healthcare landscape is making me seriously reconsider this plan.

As a family doctor, my job is to comprehensively care for my patients across a wide variety of health problems. Living in a state that seeks to further restrict abortion access, criminalizes exploration of gender identity and still hasnt expanded Medicaid for over 10 years after the Affordable Care Act became law threatens my professional ethos.

I am also increasingly fearful for my personal safety as I just try to do my job. My patients, all patients everywhere, deserve the best, most up-to-date medical care. North Carolina is moving in directions that propagate bad medicine and limit my ability as a physician to do the right thing.

Abortion is an essential option in pregnancy care, and is often life saving. Living a life aligned with your gender identity is also often life saving 40% of transgender youth attempt suicide each year.

Having access to health insurance to be able to afford to care for yourself and your family is lifesaving. The list of ways the North Carolina legislature has stepped in to limit my ability to care for my patients goes on and on. The Speaker of the Houses announcement recently of further proposed restrictions on abortion adds moral injury to what is already a long list of ways that the state interferes with my ability to care for my patients.

North Carolinians deserve the best medicine has to offer. Our healthcare shouldnt be subject to the state we live in, or the opinions of politicians. I am not alone in reconsidering my decision to stay in this state after I graduate residency.

North Carolina spent five years making me an excellent physician. It would be a shame to see myself and others leave the state just as we are ready to launch on our own. Abortion bans, gender affirming care bans, lack of support for comprehensive health care reform, and other limitations will force us to leave.

This brain drain will continue unless politicians get out of our exam rooms. Please trust us, your doctors, for your medical care, rather than politicians.

RebeccaE.Kasper, MD, MPH is a Family Medicine Doctor, a Primary Care Doctor and a Resident who sees patients at Duke Family Medicine Center.

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Family doctor: NC politicians making health care landscape toxic - The Fayetteville Observer

Family Medicine

Mercyhealth welcomes Dr. David Rebedew, board certified family … – Mercyhealth

Mercyhealth is pleased to welcome David Rebedew, MD, board certified family medicine doctor, to the physician staff of Mercyhealth East and Mercyhealth South, and the faculty of the Mercyhealth Family Medicine Residency Program.

Dr. Rebedew is excited to share his philosophy of care with the residents he is teaching. My philosophy of care is to combine the latest evidence with shared decision making to find out what is most important to my patients while trying to use the least amount of medications, referrals and tests to make them as healthy and happy as possible, he said. I do this through use of injections for pain, performing ultrasound to aid with diagnosis, complementary and alternative medicine, as well as teaching residents.

After earning his medical degree at University of Wisconsin School of Medicine and Public Health, Madison, Dr. Rebedew served a family medicine residency at Waukesha Family Medicine Residency Program, Waukesha, WI. He is certified by the American Board of Family Medicine.

Dr. Rebedews special interests include:

To make an appointment with Dr. Rebedew at Mercyhealth South, call (608) 755-7960. To make an appointment with him at Mercyhealth East, call (608) 756-7100.

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Mercyhealth welcomes Dr. David Rebedew, board certified family ... - Mercyhealth