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9d0c66ef9744f9af71c679f3de252cd9-huge-imApril is Occupational Therapy Month, so we invited a few occupational therapists -- including past members of our Hotspotting Learning Collaborative -- to tell us just what occupational therapists do and what that has to do with primary care. Here's what they had to say.

By David Goldstein, Jillian Fader, and Sherry Muir, PhD, OTR/L

April is occupational therapy month, but what’s occupational therapy?

Many of you probably know that occupational therapy is a health care profession that focuses on rehabilitating individuals who have physical impairments and need to regain the ability to complete daily tasks and manage basic needs. Or perhaps, you also know that occupational therapists help children with disabilities in the school system gain the skills needed to participate in school and play.

This is all true, but occupational therapy has a much wider scope than most health care professionals realize.

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Posted by Sonya Collins on Apr 28, 2016 10:43 AM EDT
25e1a3cb22e651c634b769ac0b9f8880-huge-e7For the next few weeks, Progress Notes will take a look at team-based care. What do providers think about it? How do patients feel about it? In this post from our archives, a doctor explains how patient engagement is crucial to the success of team-based care.

By Sarah Smithson, M.D.

Last week, I had a follow-up visit with one of my most energetic patients. She has truly embraced our new medical practice, Carolina Advanced Health, a patient-centered medical home that emphasizes prevention and management of chronic diseases through a multidisciplinary team-based approach. With the help of our nutritionist, in the last six months she has shed over ten pounds from her petite frame through changes in her nutrition and exercise. Her blood pressure, once borderline, is now within goal. The same is true of her blood sugar and cholesterol – her LDL dropped over 50 points without medication. Her energy fills the exam room, and she is eager to help other patients share in her success. We brainstorm together.
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Posted by Sonya Collins on Apr 21, 2016 1:59 PM EDT
5da32ab51a2430ab7a2740b0f60d7890-huge-m_For the next few weeks, Progress Notes will take a look at team-based care. What do providers think about it? How do patients feel about it? Today we hear from a doc who says clinical innovation and team-based care could dramatically change the answer to the most common patient question: When do I need to come back to see you? We not only need means of reimbursement for these models; we need to train the next generation of health care professionals to practice in these models. This post first appeared on Progress Notes in 2013 after it was published on Colorado Coalition for the Medically Underserved's blog.

By Mark Earnest, M.D., Ph.D.

“When do I need to come back and see you?”  Jane asks.

Her simple question is probably the most common question a doctor has to answer.  It comes up in literally every patient encounter. She asked it as we finished discussing the possible side effect of the new medication she will start to control her blood pressure. Like most doctors, I devoted little thought to her query and answered according to my habit and training, but her question deserves a lot more thought. How doctors like me answer this question may be the key to improving access to care and solving the looming doctor shortage. more...
Posted by Sonya Collins on Apr 14, 2016 11:36 AM EDT
6df1d7795e6b2c8f89f56831c56a914a-huge-brIt's National Public Health Week. In his editorial that originally appeared on The Huffington Post, Brian Castrucci explains why team-based care must include the public health department if it is to address social determinants of health.

By Brian Castrucci

There is increasing talk about moving "upstream" – working to prevent disease before it happens by addressing the social and environmental determinants of health – to improve health and reduce costs.

Among the champions of this approach is Rishi Manchanda, M.D. In his TED book, The Upstream Doctors, Manchanda argues for more "upstreamists" -- physicians who see their work as including a "duty not only to prescribe a clinical remedy but to tackle sickness at its source."

As an example, Manchanda recounts the story of a patient, Veronica, who suffered from severe chronic headaches. Her interaction with the health care system had resulted in inconclusive medical tests and an expensive visit to the emergency room, but no answers as to the cause of her headaches, let alone a solution.

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Posted by Sonya Collins on Apr 6, 2016 11:10 PM EDT
6f93abcabb876160ec550bfd5d4ee48d-huge-joIn honor of Social Work Month, we're reposting this piece from our archives written by a social worker looking at primary care as total responsibility—not only for the physical health of the patient, but for the betterment of their life.

By Joe Tobias

Earlier this year I heard Jack Geiger deliver Grand Rounds in the Social Medicine Department of Montefiore Medical Center. A physician well into his 80s, Geiger still travels the country promoting medicine as social rehabilitation—a model he has championed for the past fifty years. In the Mississippi Delta, in the racially divided South of the 1960s, Geiger started the nation’s first community health center. Not only did the center treat North Bolivar County residents’ acute medical problems, it also empowered them to lead better lives: to learn the skills they needed to stay healthy, to obtain the education that poverty had unjustly denied them and to realize their potential.
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Posted by Nate Leskovic on Mar 31, 2016 12:58 PM EDT
6f067015fcfe71c26f5f06b99a3c547a-huge-54Last week, you read about the experiences of medical and pharmacy students who applied for this year's Match. Here on Progress Notes, we've covered The Match for many years, and we've seen that many factors go into students' choices for where they'd like to match. Here's a list of ten of the most common factors Progress Notes contributors say that they looked for in a residency.
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Posted by Sonya Collins on Mar 22, 2016 1:08 PM EDT
9056132d346281d43d79c387bfde678b-huge-chIt's Match Day! One of the most important days in the lives of soon-to-be doctors and pharmacists, they'll learn which residency program they “matched” into and whether the Match will lead them to a clinic down the street or a hospital across the country. Match Day is the culmination of an entire season of applications and interviews. This week on the blog, read about the experiences of some class of 2016 doctors and pharmacists who will be matching today.

By Michael Chen

Interview season was fantastic. Before my fourth year of medical school, I had always heard of the “Great Fourth Year” filled with time off to relax and maybe even pick up a new hobby. While that part of my year has been much needed, going on interviews has been one of my favorite parts of this final year.

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Posted by Sonya Collins on Mar 18, 2016 12:07 PM EDT
ed5f8c97ccae371a0db18677a53d27f9-huge-kaBy Katie Daniels

Pharmacy residency is becoming an increasingly desirable career path for graduating pharmacists. It offers the opportunity to build on clinical knowledge and skills during an additional one to two years of training in a hospital setting. Much like the residencies of our physician counterparts, pharmacy residencies involve a series of rotations in different clinical settings, which may include critical care, cardiology, pediatrics, oncology, primary care, and others, depending on the resident’s interests and the program’s requirements. Responsibilities of pharmacy residents also often include staffing, research, teaching, projects, and precepting pharmacy students. Going into pharmacy residency is not for everyone, but it does provide alternative career paths for pharmacists interested in clinical care. It can also offer a competitive edge in the job market. more...
Posted by Sonya Collins on Mar 17, 2016 11:10 AM EDT
3a6e82129a1c059884070025b4c9320d-huge-98This Friday, March 18, is Match Day for soon-to-be docs and pharmacists. One of the most important days in the lives of these health care professionals, they'll learn which residency program they “matched” into and whether the Match will lead them to a clinic down the street or a hospital across the country. Match Day is the culmination of an entire season of applications and interviews. This week on the blog, read about the experiences of some class of 2016 doctors and pharmacists who will be matching this Friday.


By Diana Wohler

There are over 400 family medicine residency training programs in the United States, which is absolutely exhilarating (so many possibilities!) and daunting (so MANY possibilities). To tackle this, my husband and I first made some strategic geographical decisions – key for anyone entering the couples match. As my husband is from the Midwest and my family lives in southern New England, we narrowed down our potential programs to those two areas. 
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Posted by Sonya Collins on Mar 16, 2016 11:04 AM EDT
dbac56b594c8c78953086b6688ee60d5-huge-brThis Friday, March 18, is Match Day for soon-to-be docs and pharmacists. One of the most important days in the lives of these health care professionals, they'll learn which residency program they “matched” into and whether the Match will lead them to a clinic down the street or a hospital across the country. Match Day is the culmination of an entire season of applications and interviews. This week on the blog, read about the experiences of some class of 2016 doctors and pharmacists who will be matching this Friday.

By Isha Marina Di Bartolo

“What are your values?” During a presentation about the interview process and how to select a residency program, our dean’s call to think about our values left me thinking about what was important to me in the face of all the decisions I would be making over the next few months.

I began the application process knowing only that I wanted to apply in internal medicine. I had just finished a sub-internship in medicine at St. Raphael’s Hospital, which I began full of trepidation. I was certain that I would somehow disappoint my residents and attendings, by stuttering through a presentation at rounds, forgetting an important element of the abdominal exam for an ascitic patient or just generally messing up due to my ignorance or ineptitude. Only some of these fears came true, and overall, I left the rotation feeling ready for my formal residency training. I felt sure that internal medicine was right for me. I didn’t mind the four-hour rounds; I loved the holistic approach to the patient; and I enjoyed collaborating on interdisciplinary teams.
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Posted by Sonya Collins on Mar 15, 2016 10:23 AM EDT
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