New Primary Care Guidelines and what you need to know
PCP changes for various health conditions that you should be aware of
A Medscape article by Dr. Neil Skolnik on January 17th, 2024, reported guideline changes for primary care practitioners for 2024. I am touching on a few of the health issues mentioned in the article.
I did not touch on COPD, heart failure, prescribing in older adults, vaping, or osteoporosis, so check out the article if you want to know more about changes regarding those health conditions.
Mammogram Changes
I have already mentioned some good news for those who get a mammogram: they must now provide your breast density result. They still will not encourage an ultrasound for women who fall into class 4 even though they know a mammogram may not pick up your cancer, so you may have to demand an ultrasound if you do fall into this category.
Hypertension Changes
Another positive change I found was that the blood pressure reading for hypertension treatment had been charged from <130/80 to < 140/90.
Depression Changes
For mild depression, the recommendation is to first refer the patient for cognitive-behavioral therapy before medication, but if CBT isn’t available, then prescribe an antidepressant.
For moderate and severe depression, they will still suggest CBT but with an antidepressant medication and may augment that medication with another medicine.
I could go on and on about how I disagree with the allopathic medical approach for depression, but at least offering therapy first before meds for mild depression is at least a tiny step in the right direction.
Menopausal Symptoms
This is where I got a bit angry. The first line of treatment is synthetic estrogen, but they state now that if a patient wants to skip the synthetic estrogen because of the increased breast cancer risk along with increased deep vein thrombosis and pulmonary embolism, the doctor can discuss weight loss.
That doesn’t even make sense to me. Plenty of women who do not need to lose weight still suffer from menopausal symptoms!
His next sentence was this:
“Supplements don’t work.”
While I have many professional books filled with research with citations on herbal benefits for a host of health issues, including symptoms during menopause, a quick Google search provided numerous articles at NIH supporting herbs for menopausal symptoms.
In the next sentence, he goes on to mention all the medications they can use for menopausal symptoms, such as antidepressants or gabapentin (a drug with a host of side effects that is also difficult to taper off, which I reported about in a previous post).
Fatty Liver Disease
Well, at least they mention testing for ferritin levels and a celiac disease panel and “can receive diet and lifestyle advice.”
What the article completely ignores!
What would be nice to see under all these new guidelines is to refer the person to a nutritionist.
Hypertension? We can help with that.
Depression with no known trauma/abuse reason why, we can look at underlying root causes for that mental health issue.
Heck, even with psychological issues, nutrition help is often very helpful. Just think about what happens to your nutrient status when your body is under a chronic state of stress (depression) and the person with depression has no motivation to eat healthy.
Menopause? There are numerous options outside of antidepressants, such as herbs, dietary changes, and BHRT. But none of this was mentioned in the article.
No, it's the same old pill for an ill with slight updates.
Unfortunately, westernized medicine lives in a small box with thick walls, and they do not let any alternative option in, nor do they venture outside of their small box to examine all the potential possibilities to help their patients.
I am not saying they have to be knowledgeable about alternative options, but they should have a list of professionals to which they can refer their patients.
After all, it isn’t about giving the best care to the patient, and if you are unable to do so within your scope, be honest about that and refer to someone who can.
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