Population health, colorectal cancer screening, and guideline development

Although a recent vacation and catching up after returning to work have delayed posting to the blog, I wanted to share three of my recent publications in other venues that you might find to be of interest. In my latest Medscape commentary, I added my voice to an ongoing debate about the future role of family physicians in addressing population health and social determinants. Should we expect all family physicians to be "experts in population health," or limit population health training to basic competencies that are generally tied to clinical settings?

My view is that medical schools and residency programs should offer a scope of population health training that falls somewhere in between Dr. DeVoe's aspirational goals and Dr. Campos-Outcalt's minimum objectives, consistent with their institutional mission statements, faculty resources, and existing connections with community organizations. 

For example, over the past several years, my students and family medicine residents have benefited from classroom and experiential learning from faculty in Georgetown's Department of Health Systems Administration, its law school, and its school of public policy. Each year we raise the bar for population health in undergraduate medical education so that our graduates will be able to utilize population health skills in residency and, if desired, incorporate them into their future practices.

Meanwhile, over at American Family Physician, fellow Deputy Editor Mark Ebell, MD, MS and I launched a feature that evaluates new diagnostic tests:

[Diagnostic Tests: What Physicians Need to Know] uses a structured approach to review key test characteristics, including discussions of accuracy, benefits, harms, cost, and cost-effectiveness. It concludes with a clinical bottom line: Is there a role for this test in primary care practice and, if so, for which patients? We aim for this new feature to cut through the “hype” and provide independent, objective assessments of new diagnostic tests that readers are considering incorporating into their practices.

Family physicians and other primary care clinicians who read AFP can find my first piece in the series, mSEPT9 Blood Test (Epi proColon) for Colorectal Cancer Screening, in the July 1 issue of the journal.

Finally, on the AFP Community Blog, I took readers "behind the scenes" of the updated American Academy of Family Physicians (AAFP) clinical practice guideline on depression following acute coronary syndrome events. Those of you who are interested in learning more about how the AAFP develops guidelines can check out some of their background resources, such as a short video series and the detailed Clinical Practice Guideline manual. I am currently working with the AAFP to develop clinical practice guidelines on two common conditions encountered by family physicians.

As Common Sense Family Doctor approaches its 10-year anniversary (July 24, 2019), topics on deck for future posts include artificial intelligence (AI) in primary care, the upside of clinical inertia, and more developments in overdiagnosis. Stay tuned.