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The decision to prescribe statins or not to prescribe statins is made multiple times a day in the offices of osteopathic family physicians. The estimation of overall cardiovascular risk is key to deciding response to the lipid panels we order daily. Employer based insurance plans require patients in my region to have lipid panels drawn even though they are not indicated either by age or frequency. It is unlikely that these groups of patients are going to need statins if they have no comorbidities. Beyond that, the use of cardiovascular calculators are the standard of care in 2015 in patients who do not have diabetes, hypertension or known heart disease. The article in this issue uses several cases to illustrate key points to statin prescribing. This is an area where a well-designed electronic medical record could be helpful. It is a computer after all and calculations and lists are what computers do best.
Mood disorders are common in primary care and the article in this issue discusses the spectrum of mood disorders including dysthymia, unipolar and bipolar depression. It is a challenge to care for these conditions in a 15-minute appointment. As I find myself time challenged trying to cope with a first appointment with one or more of these conditions and I walk out of the room late for the rest of the day, it helps me better understand why psychiatrists and psychologists have longer initial booking times for psychiatric conditions.
Sexual counseling is fairly common in primary care and this issue includes an article on the topic of sexual counseling and cardiovascular disease. It outlines several assessment tools not handy in my office on a daily basis so the author is probably right that more training of primary care physicians is probably in order. The article talks about advising patients with angina, after a myocardial infarction, after bypass surgery, or ICD placement plus other conditions commonly seen in primary care when it is safe to have sex.
We are running a summer edition of common skin conditions with pictures. This month has a case of photodermatitis, which brings back memories of the time my family lived in South Florida and my father had a coworker who grew limes. The gentleman would bring to the office those that were too big to sell, and we made limeade by the gallon. One of my siblings developed a photodermatitis as a result. My parents were so impressed with the doctor’s ability to diagnose this condition.
Let us know what you think of the dermatology section. We are trying to do a visual item like dermatology or radiology on a regular interval – of course depending on the quality of the submissions.