Monday, January 8, 2018

The top ten AFP Community Blog posts of 2017

- Kenny Lin, MD, MPH and Jennifer Middleton, MD, MPH

For the first time since we started putting together lists of the year's most-read posts, three guest posts made the 2017 list, including the top two. We welcome submissions of guest posts from readers on topics of interest to family physicians; please send inquiries and submissions to

1. Guest Post: I have a new patient (January 3) - 1952 page views

I realize, again, that sometimes we family physicians are called to comfort and not cure. I see how filling her remaining days by helping others continues to bring her a sense of purpose. I have learned a great deal from her in a short time and am grateful that I accepted a new patient.

2. Guest Post: On the front lines of the opioid epidemic (February 21) - 1843 page views

We decided to stop prescribing opioids for chronic pain management. All patients were reassessed and alternatives were chosen to manage pain. So many negative stories started with “A doctor prescribed these medications, so I thought they were okay.” Going forward, prevention, identifying those at risk, and asking questions about abuse is our focus.

3. What's in a name? Obesity, ABCD, and prediabetes (January 10) - 1558 page views

For all its limitations, obesity is a diagnosis with well-established clinical utility. It is less clear how many patients have been helped (or harmed) by being diagnosed with prediabetes. With more study, adiposity-based chronic disease might someday become a useful term, but the current case for more widespread use is unconvincing.

4. The 2017 ACC/AHA Clinical Practice Guideline for High Blood Pressure (November 27) - 1281 page views

It's difficult to argue with this CPG's emphasis on nonpharmacologic treatment, ambulatory BP monitoring, team-based care, integration of QI efforts, and population health advocacy. Its new BP diagnosis definitions and treatment goals, however, may be more open to discussion, especially as no primary care societies were involved in their development.

5. Strategies to limit antibiotic resistance and overuse (June 26) - 1170 page views

According to a report from the Centers for Disease Control and Prevention (CDC), more than 2 million Americans become infected with antibiotic-resistant bacteria each year, leading directly to at least 23,000 deaths and contributing indirectly to thousands more.

6. Safety net doesn't shield patients from low-value care (April 17) - 1147 page views

The study authors found no consistent relationship between insurance status and quality measures, and they concluded that safety net physicians were just as likely as other physicians to provide low-value services.

7. After emergency contraception: what next? (January 21) - 1011 page views

Discussions about EC should include options for initiating a regular form of contraception along with information about ulipristal's effectiveness and possible interactions. Providing this information to women will allow them to choose both an EC method and a regular contraceptive method that best fit their priorities and wishes.

8. Simplifying treatment of acute asthma (March 27) - 978 page views

For the time being, we'll need to use patient-centered decision making to arrive at the best treatment plan for each patient with acute asthma, though it certainly seems reasonable to consider shorter durations of oral corticosteroids in uncomplicated pediatric and adult patients.

9. Guest post: innovating connections in family medicine (February 6) - 970 page views

While I delight in new technology that enhances our care for patients, some aspects of family medicine won’t change. Technology won’t change the reassuring words we can offer to a worried parent or acutely ill patient. It won’t alter the power of our receptive ears being present for a scared patient. And it definitely won’t replace the wisdom, laughs, perspectives, and connections we encounter with our patients each day.

10. Vaccines in the news: controversies & updated recommendations (February 15) - 970 page views

Countering anti-vaccine messages can feel challenging, but the best predictor of being vaccinated is still hearing a physician's recommendation to vaccinate. Arming ourselves with information and strategies can help our patients make informed choices about vaccination.