Inside Family Medicine

In this episode of Fighting for Family Medicine, David Tully, AAFP vice president of government relations, reviews June advocacy efforts, including the Family Medicine Advocacy Summit, where more than 300 physicians advocated for policies to improve access to care. He also highlights AAFP positions on H-1B physician policy, Medicaid work requirements, ACA marketplace changes, rural training and hospital payments, and reducing prior authorization burdens. Tully then discusses student loan changes from the U.S. Department of Education under H.R.1 with members of the AAFP government relations team, Meagan Mortimer and Mandi Neff, outlining new repayment rules, elimination of programs and borrowing caps,. Topics by Timestamp 00:00 Student Loan Changes Ahead 01:02 June Advocacy Wins 02:17 Policy Updates Roundup 05:26 DOE Loan Overhaul Explained 06:19 AAFP Pushback on HR1 08:42 Borrowing Caps Timeline 10:28 Exceptions and Legacy Plans 11:48 Mitigation and Advocacy Strategy 15:58 How Members Can Help 18:26 Closing and Disclaimers Additional Resources Blog: Policymakers have a roadmap to ease medical student debt Advocacy topic: Medical student debt relief Managing student loan debt Loan repayment strategies for medical students and residents Letter to the Department of Education to Protect Medical Training Pathways AAFP on X: "Every patient deserves access to a family physician. The AAFP is encouraged by a federal court's decision to halt the proposed $100,000 H-1B application fee. We urge Congress to pass the bipartisan H-1Bs for Physicians and the Healthcare Workforce Act, which would codify this https://t.co/mDqeYPpi8L" / X AAFP on X: "The AAFP is deeply concerned that Medicaid work reporting requirements will result in massive coverage losses for beneficiaries. When patients can access Medicaid, communities are healthier. https://t.co/ZvAx2In0Nm https://t.co/7fd9LjIAiC" / X Speak Out: Support the Medicare Advantage Improvement Act of 2026 Letter in Resposne to IPPS Rule Speak Out: Chronic Care Management Improvement Act Speak Out: Support H-1B Physicians Primary Care Innovation Network Disclaimer: Copyright 2026, AAFP. The views presented in this broadcast are the speaker's own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. The AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.

In this re-released episode of CME on the Go, originally published on 12/1/2025, our hosts discuss the complexities of diagnosing and treating headaches in primary care. They cover common challenges faced by family physicians, such as differentiating between primary and secondary headaches, the importance of taking thorough patient histories, and the appropriate use of diagnostic tests like MRI and CT scans. The episode offers a deep dive into treatment options for headaches, including pharmacologic and non-pharmacologic methods, with a special focus on managing chronic daily headaches, migraine disorders, and medication overuse headaches. The discussion also touches on the role of cognitive behavioral therapy, osteopathic manipulation, and the efficacy of various medications like NSAIDs, triptans, and beta blockers. After listening to the podcast episode, claim 0.5 AAFP credit by following the provided link. https://www.aafp.org/assessment/take/19579/e Learning Objectives Apply a standardized, evidence-informed diagnostic and treatment algorithm for evaluating patients with headache, while acknowledging alternative approaches. Differentiate between appropriate and potentially problematic interventions, including the use of narcotics, in-office procedures, and newer pharmacologic therapies. Reflect on provider discomfort and fatigue in managing headache complaints, and develop strategies to maintain empathy, clinical consistency, and patient rapport. References and Resources Bahra, A., & Evans, R. W. (2021). The secondary headaches. Cephalalgia, 41(4), 427-430. Jairo Hernandez, Eduardo Molina, Ashley Rodriguez, Samuel Woodford, Andrew Nguyen, Grace Parker, Brandon Lucke-Wold. Headache Disorders: Differentiating Primary and Secondary Etiologies. J. Integr. Neurosci. 2024, 23(2), 43. https://doi.org/10.31083/j.jin2302043 https://www.sciencedirect.com/science/article/pii/S1470211823000052#bib0003 Novel screening tool for secondary headache in acute care—A pilot study. https://doi.org/10.1016/j.clinme.2023.100005 https://ichd-3.org/ Disclosure: It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All individuals in a position to control content for this session have indicated they have no relevant financial relationships to disclose. Disclaimer: Copyright 2026. AAFP. The views presented in this broadcast are the speaker's own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.

In this episode of CME on The Go, our hosts discuss a postpartum patient with painful breastfeeding and concerns about milk supply. They emphasize listening, cultural context, and early breastfeeding discussions. The episode reviews baby‑friendly hospital practices, noting risks when taken too far, and affirms that formula supplementation may be appropriate. Practical guidance includes assessing latch and positioning, supportive tools, tongue‑tie considerations, and concludes with neonatal circumcision as an elective, culturally influenced procedure. Learning Objectives Evaluate the current evidence and identify gaps regarding tongue tie, neonatal circumcision, and breastfeeding. Apply effective, empathetic communication strategies utilizing shared decision-making with patients and caregivers in regard to tongue tie, neonatal circumcision, and breastfeeding. The AAFP has reviewed Tiny Ties & Big Opinions: Hot Takes in Peds and deemed it acceptable for up to 0.50 Enduring Materials, Self-Study AAFP Prescribed credits. Term of Approval is from 03/23/2026 to 6/4/2027. Physicians should claim only the credit commensurate with the extent of their participation in the activity. The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The American Academy of Family Physicians designates this Enduring Materials for a maximum of 0.50 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. CME activities approved for AAFP credit are recognized by the AOA as equivalent to AOA Category 2 credit. After listening to the podcast episode, claim 0.5 AAFP credit by following the provided link. https://www.aafp.org/assessment/take/19731/e References and Resources https://firstdroplets.com/ https://womenshealth.gov/breastfeeding/learning-breastfeed/getting-good-latch https://my.clevelandclinic.org/health/articles/breastfeeding-latch https://my.clevelandclinic.org/health/articles/5182-breastfeeding https://nurturingmilk.com/how-to-get-a-deep-latch/ https://www.sbcc.sg/breastfeeding-101-tips-for-first-time-mums/ Disclosure: It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All individuals in a position to control content for this session have indicated they have no relevant financial relationships to disclose. Disclaimer: Copyright 2025. AAFP. The views presented in this broadcast are the speaker's own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.

Host Michael Monroe interviews Dr. Brianna Wynne, a board-certified geriatric medicine physician, about how family physicians can support prevention, screening, and early detection of cognitive aging and Alzheimer's disease. Dr. Wynne distinguishes normal aging (slower processing speed) from mild cognitive impairment (objective test deficits with preserved function) and dementia as a spectrum from mild functional difficulties with instrumental activities to severe end-stage dependence. She describes how concerns typically surface through caregivers or during routine visits such as Medicare annual wellness visits and emphasizes proactive questioning. She highlights practical tools and resources including the Mini-Cog, AAFP shared decision-making guidance to help differentiate dementia types, the Alzheimer's Association for patient and caregiver support, and familydoctor.org for accessible, bite-sized clinical information. Topics By Timestamp 00:00 Welcome and Guest Intro 00:47 Dr. Wynne Background 01:40 Cognitive Decline Basics 05:11 What Family Docs See 07:05 Starting the Conversation 08:51 Screening Tools and Resources 11:18 CME and Quick References 12:22 Future of Dementia Care 14:38 Wrap Up Additional Resources 6 tips for talking about brain health across the lifespan Brain Health: Clinical Guidance and Practice Resources | AAFP Dementia | Family Doctor Alzheimer's Disease | Family Doctor Evaluation of Suspected Dementia | AAFP Disclaimer: Copyright 2026. AAFP. The views presented in this broadcast are the speaker's own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.

In this episode of CME On the Go, our hosts revisit menopause through a case of a 51-year-old with seven months of amenorrhea, vasomotor and cognitive symptoms, and osteopenia-range DEXA findings, highlighting that she is perimenopausal. They note the limited role of FSH/LH testing and the need to rule out other causes. The episode focuses on systemic hormone therapy, recommending 17β-estradiol with progesterone for patients with an intact uterus, favoring transdermal routes for lower risk, gradual dose titration, shared decision making, and supportive lifestyle measures. Learning Objectives Learn how to select proper dosing and route of administration for estrogen replacement therapy including initiation, adjustments through monitoring, and discontinuation. Discuss non-medicinal strategies for healthy aging in the menopausal woman including issues around sleep management, general cardiovascular fitness, and dementia. The AAFP has reviewed Hot Takes and Flashbacks of Menopause and deemed it acceptable for up to 0.50 Enduring Materials, Self-Study AAFP Prescribed credits. Term of Approval is from 03/09/2026 to 6/4/2027. Physicians should claim only the credit commensurate with the extent of their participation in the activity. The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The American Academy of Family Physicians designates this Enduring Materials for a maximum of 0.50 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. CME activities approved for AAFP credit are recognized by the AOA as equivalent to AOA Category 2 credit. After listening to the podcast episode, claim 0.5 AAFP credit by following the provided link. https://www.aafp.org/assessment/take/19730/e References and Resources Menopause and Perimenopause Livestream: https://www.aafp.org/cme/all/womens/menopause-perimenopause-hrt.html Menopause Management: When Hormone Therapy Is Appropriate: https://www.aafp.org/pubs/afp/issues/2026/0200/editorials-menopause-management.html Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2017.16952?utm_source=openevidence&utm_medium=referral Blog Article: More people than ever are interested in menopause. Family physicians should be, too: https://www.aafp.org/news/blogs/aafp-voices/menopause-perimenopause-education.html ACOG President Says Label Change on Estrogen Will Increase Access to Hormone Therapy: https://www.acog.org/news/news-releases/2025/11/acog-president-says-label-change-on-estrogen-will-increase-access-to-hormone-therapy https://www.webmd.com/menopause/which-type-of-estrogen-hormone-therapy-is-right-for-you https://www.ncbi.nlm.nih.gov/books/NBK493191/ https://pmc.ncbi.nlm.nih.gov/articles/PMC12463494/#:~:text=Estrogen%2C%20with%20or%20without%20progestogen,genitourinary%20symptoms%20after%20medication%20termination. The NAMS 2017 Hormone Therapy Position Statement Advisory Panel. The 2017 hormone therapy position statement of The North American Menopause Society. Menopause. 2017;24(7):728-753. doi:10.1097/GME.0000000000000921 . Yet, the latest update from WHI showed that HT with CEE + MPA or with CEE alone was not associated with risk of all-cause, cardiovascular or cancer mortality during a cumulative follow-up of 18 years (Manson et al., 2017 Manson JE, Aragaki AK, Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Chlebowski RT, Howard BV, Thomson CA, Margolis KLet al. Menopausal hormone therapy and long-term all-cause and cause-specific mortality: the Women's Health Initiative randomized trials. JAMA 2017;318:927–938. Clare Oliver-Williams, Marija Glisic, Sara Shahzad, Elizabeth Brown, Cristina Pellegrino Baena, Mahmuda Chadni, Rajiv Chowdhury, Oscar H Franco, Taulant Muka, The route of administration, timing, duration and dose of postmenopausal hormone therapy and cardiovascular outcomes in women: a systematic review, Human Reproduction Update, Volume 25, Issue 2, March-April 2019, Pages 257–271, https://doi.org/10.1093/humupd/dmy039 Disclosure: It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All individuals in a position to control content for this session have indicated they have no relevant financial relationships to disclose. Disclaimer: Copyright 2025. AAFP. The views presented in this broadcast are the speaker's own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.