cover story one
Health Care at the Crossroads
Securing the future of patient care
BY Lisa Schweiger, MD, and Nick VanOsdel, MD
The human psyche is remarkably adept at normalizing. While this confers an exceptional capacity for resilience, this plasticity frequently allows for the disallowable. Physicians are not immune to this. Health care leadership in the United States has undergone a disturbing transformation in the past 15+ years, as it has changed from a small scale, local and regional model led by physicians, to a system increasingly dominated by multi-state, national and multi-national corporations. What once seemed like a necessary trading of autonomy in pursuit of a lighter administrative burden, more resources and more time with patients has led to a disorienting shift in priorities, as the foundation of patient-centered, physician-led care moves under the influence of a customer-based lean and profitable large-scale business model
cover story two
Talking to Adolescent Patients: A new toolkit to improve communication
By Katie Pierson, MA, Renee Sieving, PhD, RN, and Christopher Mehus, PhD, LMFT
Most primary care physicians have adolescent patients and most recognize there are unique issues in treating them. As trusted sources of information, physicians can play important roles in helping young people make good choices and develop healthy behaviors. In so doing, how something is said to a young person is often just as important as what is said.
Pain Management
Prevention and Treatment of Osteoporosis: Beyond the basics
By Erin Bettendorf, MD, and Andrew Cozadd, PA-C
Os steoporosis is a skeletal disorder characterized by low bone mineral density, poor bone quality, and decreased bone strength, which is likely to lead to bone fractures in older individuals. Worldwide, 50% of older women and 25% of older men are at risk of bone breaks due to osteoporosis, and studies indicate that one in three women over age 50 and one in five men will experience fractures. In the U.S. the disease is pervasive and affects millions, nearly 80% of whom are women. Of the roughly 65 million Med
Dementia Care
The GUIDE Model: Guiding an improved dementia experience
By Morgan Daven
On July 1, 2024, CMS launched a new research trial to develop new protocols for supporting people with dementia and their unpaid care givers. The number of participants required for the voluntary nationwide model test filled quickly and research will be gathered over the next eight years. The Guiding an Improved Dementia Experience (GUIDE) model involves comprehensive, coordinated dementia care and ways to improve quality of life for people with dementia, reduce strain on their unpaid caregivers and enable people with dementia to remain in their homes and communities.
INTERVIEW
Taking it to the Street
Beth Kangas, PhD, executive director, Zumbro Valley Medical Society (ZMVS) and Foundation, director, ZVMS Street Medicine
Street medicine brings health care out of traditional clinical settings to people where they are, specifically those experiencing homelessness. Many street medicine programs concentrate on serving unsheltered or rough-sleeping individuals. However, because the unhoused population in Olmsted County is relatively small compared to Los Angeles or other large cities, Zumbro Valley Medical Society (ZVMS) Street Medicine serves people experiencing any of the full range of unstable housing: sleeping in parks and cars, staying in shelters, couch surfing, as well as those transitioning to stable housing and those in permanent supportive housing.
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