Inside Family Medicine

Hosted by American Academy of Family Physicians

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Jun 2026

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A podcast produced by the American Academy of Family Physicians for family doctors and related health care professionals.

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June 8, 202622 min

IFM | FASDs in Primary Care: Recognition, Prevention, and Support

AAFP Chief Medical Officer and Senior Vice President of Education, Inclusiveness and Physician Well-Being Margot Savoy, MD, MPH, FAAFP, welcomes back Jeffrey Quinlan, MD, FAAFP, a family physician and University of Iowa department leader with a 28-year US Navy career, to discuss his AAFP work on fetal alcohol spectrum disorders (FASDs) and substance use in pregnancy. He emphasizes that alcohol is a teratogen with no safe amount or timing in pregnancy and outlines associated neurodevelopmental, craniofacial, organ, growth and behavioral effects. The conversation covers primary care screening and early identification using exposure history and clinical signs, common diagnostic frameworks (COFASP and the University of Washington 4-digit code), multidisciplinary care coordination and prevention through routine screening (AUDIT-C or NIAAA single-question), preconception counseling and stigma reduction. For longitudinal care, Quinlan highlights early intervention, individualized care plans, family support and training, school accommodations, behavioral therapies, nutrition support and medications for comorbid conditions, all using a strength-based approach. Topics by Timestamp 00:00 Welcome and Guest Intro 00:51 Clinical Background and Exposure 01:55 No Safe Alcohol in Pregnancy 04:02 Screening and Diagnosis Basics 06:46 Building the Care Team 09:05 Preventing Alcohol Exposed Pregnancy 12:38 Long Term Care and Interventions 20:13 Key Takeaways and Closing Additional Resources Clinician Resources Substance use disorders: Clinical guidance and practice resources from the AAFP Alcohol use during pregnancy and fetal alcohol spectrum disorders: Educational supplement on improving screening, diagnosis and treatment of children and families with FASDs, and improving support services and access to care for impacted women and families IFM | Medical insights on cannabis and alcohol use during pregnancy: Jeffrey Quinlan, MD, FAAFP, addresses alcohol and cannabis use during pregnancy in primary care Treating excessive alcohol use: Guidance for screening, diagnosing and treating excessive alcohol use in primary care settings Tobacco and nicotine use | Prevention and cessation resources: Comprehensive toolkit to assist in helping patients stop smoking or prevent them from starting Patient Resources Substance use disorder: Evidence-based patient educational resource Opioid addiction: Evidence-base patient educational resources Related AAFP CME Activities Substance Use Disorders Edition 2: CME meeting DEA-mandated eight hours of Medication Access and Training Expansion (MATE) Act Addiction Treatment and Care CME for Family Physicians: Free, on-demand CME to gain deeper understanding of the neurobiology and psychosocial dimensions of substance use disorders, and learn practical strategies to integrate harm reduction, trauma-informed approaches and culturally responsive care into your practice Funding Statement: This activity is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1,219,331 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. 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.

June 5, 202635 min

CME | Menopause, Minus the Mystery: What Every Clinician Should Know

In this re-released episode of CME on the Go, originally published on 9/2/2025, our hosts delve into menopause, providing family physicians with essential insights, treatment options, and the latest research findings. While discussing hormone replacement therapy, non-hormonal treatments, and the interpretation of the Women's Health Initiative, the hosts emphasize patient-centered care and the natural progression of menopause. This episode aims to equip physicians with practical tools and knowledge, enhancing their ability to support patients through this critical stage of life. Learning Objectives Recognize the spectrum of menopausal symptoms across age groups, including premature menopause, and assess appropriate treatment and contraceptive options. Evaluate the risks and benefits of hormone therapy in postmenopausal women, including red flags that warrant closer monitoring or alternative management. Recommend evidence-based non-hormonal strategies for managing menopausal symptoms and support patient-centered conversations that normalize and destigmatize the menopause experience. After listening to the podcast episode, claim 0.5 AAFP credit by following the provided link. https://www.aafp.org/assessment/take/18338/e Additional Resources AFP 7/2025: https://www.aafp.org/pubs/afp/issues/2025/0700/editorials-menopausal-hormone-therapy.html AFP 7/2023: https://www.aafp.org/pubs/afp/issues/2023/0700/menopausal-symptoms.html AFP 5/2025: Testosterone for menopause?: https://www.aafp.org/pubs/afp/issues/2025/0500/fpin-ci-topical-testosterone-menopausal-symptoms.html The Menopause Society with certification: https://menopause.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.

May 29, 202626 min

FFFM | FamMedPAC: How Family Physicians Engage in Policy and Politics

In this episode of Fighting for Family Medicine, David Tully, AAFP vice president of government relations, previews recent AAFP advocacy updates and interviews Domenic Casablanca, MD, FAAFP at FMX about the Family Medicine Political Action Committee (FamMedPAC). Highlights include urging HHS to preserve family medicine representation on the United States Preventive Services Task Force, AAFP advocacy efforts around Medicare payment reform and student loan repayment updates. Casablanca explains how a political action committee pools member donations to support vetted, bipartisan candidates, describes the importance of relationship-building with lawmakers and cites AAFP advocacy wins. He also shares how physicians can stay involved and make their voices heard. Topics by Timestamp 00:00 Welcome and Episode Setup 00:38 Advocacy Highlights Roundup 01:34 Medicare Payment Reform Push 02:40 Workforce Loans and Visas 04:33 Pharmacist Services Concerns 05:22 Meet the FamMedPAC Chair 06:11 What a PAC Does 06:56 Easy Ways to Advocate 08:29 How Candidates Are Chosen 09:50 Why Bipartisan Matters 11:38 Relationship Building Stories 13:44 Election Cycle Strategy 16:28 PAC Wins for Family Medicine 18:25 Hot Policy Issues Now 20:41 Career Advice for New Docs 24:10 Final Call to Engage 25:13 Wrap Up and Resources Additional Resources Op-ed: Making America healthy again needs more than a committee [2026-04-14] Kaine & Courtney Lead Bicameral Resolution to Repeal... ICYMI: Congresswoman Schrier Introduces Bipartisan Legislation to Expand Childhood Vaccine Access | Representative Kim Schrier Will AI destroy or boost healthcare? Medical professionals weigh in Physician groups react to visa freeze reversal with praise, questions Joint Letter Requesting National Interest Exceptions and Expedited Visa Processing for Physicians - April 8, 2026 Furr Testimony Health Hearing: Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms 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.

May 20, 202633 min

IFM | Whole Health: Medicine's Course Correction

In this episode of Inside Family Medicine Andrew Bazemore, MD, MPH, and Beth Polk, MD, FAAFP join us to discuss whole health in primary care. Dr. Bazemore distinguishes whole health (physical, behavioral, spiritual and socioeconomic well-being across individuals, families and communities) from whole health care (how care is organized), emphasizing a shift from "What's the matter with you?" to "What matters to you?" Dr. Polk connects whole health to lifestyle medicine's pillars and stresses addressing drivers of outcomes beyond the exam room, including social needs. They cite examples from the VA whole health model and community health centers, discuss team-based care, group visits and using existing evaluation and management (E/M) billing while advocating for payment reform. The episode highlights training needs in residency programs, small, actionable practice changes, clinician well-being and the risks and opportunities of AI in supporting whole health. Topics by timestamp 00:00 Welcome and guests 01:25 Why family medicine 03:36 Why whole health now 05:22 Defining whole health 08:22 Lifestyle medicine link 10:54 Principles and team care 13:03 Real-world examples 16:09 Billing and payment reality 22:05 Training and resources 25:57 Takeaways and next steps 29:51 Salutogenesis explained 30:57 AI and closing Additional resources Family Physicians: Leaders in Whole Health AAFP Pilot Program Shows Value of Lifestyle Medicine Prevention & Wellness Scaling Whole Health Strategies in Primary Care: Action Brief 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.

May 18, 202631 min

CME | From Awkward to Affirming: Mastering the Sexual History

In this episode of CME On the Go, our hosts discuss how family physicians can take a comprehensive, sensitive sexual history. They highlight common discomfort and bias in asking "Are you sexually active?" and emphasize using respectful, gender-inclusive language, humility, trauma-informed care and clear medical purpose to avoid voyeurism, with supportive EHR documentation when possible. They review terminology around sex, gender and sexuality and outline the CDC "Five Ps" framework—partners, practices, protection from STIs, past history of STIs and pregnancy intention—adding two additional Ps: permission and primary sexual and gender identity. They suggest open-ended questions, assess STI risk and prevention, address sexual function and trauma and revisit the sexual history during major life transitions. Learning Objectives Recognize the clinical and relational consequences of poorly conducted sexual histories, including the role of implicit bias and documentation challenges in EMRs and patient portals. Differentiate between sex, gender, and sexual identity to enhance inclusive, respectful communication during sexual history taking. Demonstrate strategies to reduce personal discomfort and foster a safe, affirming environment for patients during sensitive conversations. The AAFP has reviewed From Awkward to Affirming: Mastering the Sexual History and deemed it acceptable for up to 0.50 Enduring Materials, Self-Study AAFP Prescribed credits. Term of Approval is from 05/18/2026 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/19939/e References and Resources Yale Reflections – Gender Glossary A clear, accessible glossary of terms related to sex, gender and sexual orientation. https://reflections.yale.edu/article/sex-gender-power-reckoning/gender-glossary CDC – Taking a Sexual History CDC guidance on taking an inclusive, patient-centered sexual history in clinical care. https://www.cdc.gov/sti/hcp/clinical-guidance/taking-a-sexual-history.html American Family Physician – Sexual Health History: Techniques and Tips Evidence-based strategies for comprehensive, affirming sexual health histories in primary care. https://www.aafp.org/pubs/afp/issues/2020/0301/p286.html#afp20200301p286-b3 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.

May 14, 202618 min

IFM | Mental Health Month: Behavioral Health Integration

In this episode of Inside Family Medicine, Shannon Connolly, MD, FAAFP, associate medical director at the Planned Parenthood of Orange and San Bernardino Counties, discusses family physicians' crucial role as the first and sometimes only point of contact for mental health care, especially in underserved settings. She explains how psychosocial and behavioral factors underlie many primary care challenges such as complex pain, substance use disorders and uncontrolled chronic disease. Connolly shares a patient story illustrating how integrated support (therapy, social work and appropriate medications) improved both mental health and diabetes outcomes. She outlines behavioral health integration models, including physician-delivered care, co-located primary care behavioral health and the registry-driven collaborative care model, highlighting benefits for patient outcomes and physician workload. The conversation also addresses access barriers, telehealth as a scaling strategy and the importance of destigmatizing physicians seeking mental healthcare to combat burnout, depression and anxiety. Topics By Timestamp 00:00 Welcome and Guest Intro 01:00 Why Family Medicine 01:38 Path to Behavioral Health 02:51 Family Docs as First Line 03:52 Patient Story Real Impact 06:47 What Is Behavioral Integration 07:05 Models Collaborative Care 08:46 Benefits for Patients and Docs 10:32 Access for Underserved Patients 12:12 Overcoming Implementation Barriers 13:52 Physician Mental Health Matters 16:38 Resources and Closing Additional Resources Mental and Behavioral Health Clinical Guidance | AAFP FPM Topic Collection: Behavioral Health | AAFP Integrating Behavioral Health Into Primary Care | AAFP Free CME: Behavioral Health Integration On Demand | AAFP CME collection: Mental Health and Behavior | AAFP CME Behavioral Health Integration (BHI) Collaborative | American Medical Association Compendium of behavioral health integration resources for physician practices | American Medical Association 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.

May 12, 202620 min

IFM | Innovative Diagnostic Tools and Workflows for Suspected Alzheimer's in Primary Care

In this special edition of Inside Family Medicine, sponsored by Roche Diagnostics, host Darren Sextro talks with brain health experts Deanna Willis, MD, MBA, a board-certified family physician, and Jared Brosch, MD, board-certified neurologist, on the use of blood-based biomarkers (BBBMs) in primary care settings for Alzheimer's disease and related dementias. Their discussion explores how BBBMs can make referrals more efficient and enhance the evaluation of patients with cognitive decline. The conversation highlights the value of early diagnosis and therapy referrals as well as outlines effective workflow strategies for primary care teams. This episode is brought to you by Roche Diagnostics. Topics by Timestamp 00:00 Introduction 01:03 Meet the experts 02:22 Dr. Willis' journey 04:32 Dr. Brosch's journey 05:32 Connection between family medicine and neurology 07:24 New tools for early detection 11:19 Workflow models and biomarkers 14:08 Best practices for referrals 16:35 Biomarkers in practice 19:47 Conclusion and additional resources Additional Resources: Roche Diagnostics Elecsys Phospho-Tau (181P) Plasma decision summary https://www.accessdata.fda.gov/cdrh_docs/reviews/K252163.pdf 2024 CEOi recommendations for clinical implementation of blood-based biomarkers for Alzheimer's disease: https://doi.org/10.1002/alz.14184 2025 Alzheimer's Association clinical guidelines for primary care: https://doi.org/10.1002/alz.14333 Implementing early detection of cognitive impairment in primary care to improve care for older adults: https://doi.org/10.1111/joim.20098 FPM journal article: Blood Biomarkers and Early Detection of Alzheimer's Disease and Related Dementias Brain health hub on AAFP.org including newest brain health resources Brain health resources for patients from the 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.

May 4, 202633 min

CME | Private Practice, Public Impact: Finding Your Fit in Modern Medicine

In this episode of CME On the Go, Jason Marker, MD, MPA, FAAFP and Lauren Brown-Berchtold, MD, FAAFP, discuss how private practice in family medicine is evolving and how physicians can evaluate different models in 2026. They review trends showing a shift from 50/50 self-owned vs. other-owned practices in 2016 to about 75% other-owned and 25% private practice today, note rural workforce losses, and highlight rapid growth in direct primary care (DPC) and concierge models, alongside increasing corporate ownership. They compare employed practice vs. independent practice trade-offs, outline traditional fee-for-service, DPC, and hybrid structures, define the Triple Aim and related aims, and emphasize aligning practice choice with desired autonomy, scope, patient relationships, and community investment, with resources available through AAFP. Learning Objectives Compare the structures and implications of direct primary care (DPC), fee-for-service (FFS), and hybrid practice models to identify how each can impact patient access, continuity of care, and physician satisfaction. Evaluate the trade-offs between employed and independent practice models, focusing on how physician autonomy can influence clinical decision-making, patient relationships, and practice sustainability. Formulate personalized strategies for incorporating "private practice" principles—such as relationship-based care and operational efficiency—into any clinical setting to enhance both patient experience and professional fulfillment. The AAFP has reviewed Private Practice, Public Impact: Finding Your Fit in Modern Medicine and deemed it acceptable for up to 0.50 Enduring Materials, Self-Study AAFP Prescribed credits. Term of Approval is from 05/04/2026 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/19938/e References and Resources Direct Primary Care https://www.aafp.org/family-physician/practice-and-career/delivery-payment-models/direct-primary-care.html Managing Your Practice https://www.aafp.org/family-physician/practice-and-career/managing-your-practice.html Eskew, P. M., & Klink, K. (2015). Direct Primary Care: An Alternative to Fee-for-Service. Journal of the American Board of Family Medicine. Eskew PM, Klink K. Direct Primary Care: Practice Distribution and Cost Across the Nation. J Am Board Fam Med. 2015 Nov-Dec;28(6):793-801. doi: 10.3122/jabfm.2015.06.140337. PMID: 26546656. Sinsky, C. A., et al. (2013). Joy in Practice: Innovative Professional Models. Lessons on operational efficiency. Sinsky CA, Willard-Grace R, Schutzbank AM, Sinsky TA, Margolius D, Bodenheimer T. In search of joy in practice: a report of 23 high-functioning primary care practices. Ann Fam Med. 2013 May-Jun;11(3):272-8. doi: 10.1370/afm.1531. PMID: 23690328; PMCID: PMC3659145. Physician Employment Eclipses Practice Ownership: The Ongoing Trend and Its Effect on Family Medicine JULIE HYPPOLITE, MD, MPH, BRIAN ANTONO, MD, MPH, STEPHEN PETTERSON, PhD, AND YALDA JABBARPOUR, MD Am Fam Physician. 2021;104(4):351-352 Fogarty CT, Byun H, Huffstetler AN. Family Physician Workforce Trends: The Toll on Rural Communities. Ann Fam Med. 2025 Nov 24;23(6):535-538. doi: 10.1370/afm.240549. PMID: 41285597; PMCID: PMC12751282. Zhu JM, Marsh T, Polsky D, Huntington A, Song Z. Growth In Number Of Practices And Clinicians Participating In Concierge And Direct Primary Care, 2018-23. Health Aff (Millwood). 2025 Dec;44(12):1473-1481. doi: 10.1377/hlthaff.2025.00656. PMID: 41329882; PMCID: PMC12965179. 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.

April 30, 20267 min

FFFM | April 2026 Advocacy Rounds

David Tully, AAFP vice president of government relations, recaps the AAFP's April 2026 advocacy efforts. AAFP led a coalition letter urging the Departments of Homeland Security and State to speed visa and immigration processing for international medical graduates, citing delays with J-1 waivers, H-1B extensions, and green cards that disrupt care in rural and underserved areas. AAFP warned the Department of Education that a proposed Workforce Pell rule could exclude physicians with graduate degrees from short-term training support, worsening workforce gaps. The organization backed legislation to eliminate Medicare's 20% coinsurance for chronic care management, joined a CMS convening on the new ACO LEAD model, and submitted regulatory comments opposing added administrative burden and HRSA's proposed 340B rebate model. Topics by Timestamp 00:00 April Advocacy Recap 00:34 Supporting IMG Visas 01:57 Workforce Pell Concerns 02:34 Chronic Care Management Bill 03:16 CMS ACO Lead Model 03:57 Regulatory Burden Pushback 05:01 GME IQ Data Tool 05:26 Primary Care Underinvestment 06:32 Get Involved and Wrap Up Additional Resources Hearing on "Lowering Health Care Costs for All Americans: An Examination of the U.S. Provider Landscape" | Democrats, Energy and Commerce Committee Shawn Martin Testimony to Energy and Commerce Committee Exploring Opportunities to Improve Patient Access to Care through Strategic Changes to Graduate Medical Education: A Workshop Measuring the Impact of Family Medicine Graduate Medical Education (GME) on Community Need: Introducing the GME-IQ | Annals of Family Medicine Joint Letter Requesting National Interest Exceptions and Expedited Visa Processing for Physicians - April 8, 2026 AAFP letter to HRSA on 340B Rebate Pilot RFI- April 20, 2026 AAFP Letter to FDA on Flavored Electronic Nicotine Delivery Systems AAFP Letter to CMS on CRUSH RFI LEAD (Long-term Enhanced ACO Design) Model | CMS Joint Letter in Support of Chronic Care Management Improvement Act - April 14, 2026 AAFP Response to Education Department on AHEAD PR - April 8, 2026 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.

April 23, 202631 min

CME | A Crash Course in Thyroid Confusion

In this episode of CME On the GO, the hosts discuss a practical approach to hypothyroidism, using a case of a 50-year-old woman with nonspecific symptoms (weight gain, fatigue, edema, constipation). They emphasize thorough history and physical exam, then outline key thyroid testing: TSH as the initial screening test (often with reflex free T4), free T4 for confirmation and special situations (including pregnancy), and limited uses for T3 tests. They review antibody testing (TPO for Hashimoto's, thyroglobulin antibodies in select cases) and note tests for Graves disease outside this episode. They cover sick thyroid considerations, subclinical hypothyroidism controversy, pregnancy management with tighter TSH goals and dose increases, and treatment preferences favoring standardized levothyroxine over desiccated thyroid, with limited/controversial use of combination T4/T3 therapy. Learning Objectives Interpret key thyroid laboratory tests—including TSH, T4, fT4, T3, fT3, and thyroid antibodies—within the framework of thyroid physiology and the hypothalamic-pituitary-thyroid axis. Compare the efficacy, safety, and clinical indications of thyroid hormone replacement options such as levothyroxine, liothyronine (Cytomel), and desiccated thyroid extract. Explain the clinical significance of subclinical hypothyroidism and apply evidence-based reasoning to common patient scenarios with borderline thyroid function. The AAFP has reviewed A Crash Course in Hypothyroid Confusion and deemed it acceptable for up to 0.50 Enduring Materials, Self-Study AAFP Prescribed credits. Term of Approval is from 04/20/2026 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, complete and submit the evaluation to claim 0.5 AAFP credit by following the provided link. https://www.aafp.org/assessment/take/19856/e References and Resources Hypothyroidism: Diagnosis and Treatment: https://www.aafp.org/pubs/afp/issues/2021/0515/p605.html Thyroiditis: Evaluation and Treatment: https://www.aafp.org/pubs/afp/issues/2021/1200/p609.html Hypothyroidism A Review: https://jamanetwork.com/journals/jama/fullarticle/2838457?utm_source=openevidence&utm_medium=referral Hyperthyroidism A Review: https://jamanetwork.com/journals/jama/fullarticle/2810692?utm_source=openevidence&utm_medium=referral Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism: https://www.nejm.org/doi/full/10.1056/NEJMoa1603825 Hypothyroidism: https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0140673624016143?returnurl=https:%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0140673624016143%3Fshowall%3Dtrue&referrer=https:%2F%2Fpubmed.ncbi.nlm.nih.gov%2F Article on lab testing: https://pmc.ncbi.nlm.nih.gov/articles/PMC10517335/ https://pmc.ncbi.nlm.nih.gov/articles/PMC7640752/ Ahluwalia R, Baldeweg SE, Boelaert K, et al. Use of liothyronine (T3) in hypothyroidism: Joint British Thyroid Association/Society for endocrinology consensus statement. Clin Endocrinol (Oxf). 2023;99(2):206-216. doi:10.1111/cen.14935 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.