What Are The Risks And Benefits Of GLP-1 Receptor Agonists For Weight Loss?

Why Direct Primary Care Works So Well for Small Businesses Running a small business comes with many challenges—managing budgets, keeping employees happy, and staying competitive in today’s job market. One of the biggest hurdles? Providing affordable, high-quality healthcare benefits. This is where Direct Primary Care (DPC) can make a big difference. More and more small businesses are turning to DPC as a cost-effective and employee-friendly solution. What is Direct Primary Care? Direct Primary Care is a modern approach to healthcare where patients (or employers) pay a simple monthly membership fee directly to the primary care doctor. This covers most primary care services, including: - Same-day or next-day appointments - Unlimited office visits - Telemedicine access (phone, video, or text) - Preventive care and chronic disease management - Many in-office procedures at no extra cost Because DPC cuts out insurance middlemen, both businesses and employees benefit from lower costs, more personalized care, and easier access to a doctor who knows them well. Why Direct Primary Care is a Perfect Fit for Small Businesses 1. Affordable and Predictable Costs Traditional health insurance premiums keep rising, often outpacing small business budgets. DPC offers a flat, predictable monthly fee per employee, making it easier to manage costs. Many small businesses pair DPC with a high-deductible health plan (HDHP) or cost-sharing program, which provides catastrophic coverage while DPC takes care of everyday healthcare needs. 2. Better Employee Health and Productivity When employees can actually see their doctor without long waits or high copays , they’re more likely to stay healthy. DPC doctors typically have smaller patient panels, meaning more time spent with each employee and faster appointments. The result? - Fewer sick days - Improved chronic disease management - Higher employee satisfaction and retention 3. Recruiting and Retention Advantage Healthcare is one of the most sought-after benefits employees look for. Offering Direct Primary Care shows your business cares about employee well-being—and can set you apart from competitors. 4. Simplified Healthcare for Everyone No confusing networks. No surprise bills. No frustrating insurance hoops. Employees get direct access to their primary care physician, and business owners get transparent, straightforward pricing. How Small Businesses Can Get Started with Direct Primary Care Evaluate your current healthcare costs – compare them with DPC membership fees. Decide on a benefits strategy – many businesses use DPC alongside an HDHP to cover major expenses. Partner with a local DPC practice – like Free Range Direct Primary Care, where employees get same-day care and unlimited access to their physician. The Bottom Line For small businesses, Direct Primary Care is more than just healthcare—it’s a competitive advantage. By lowering costs, improving employee health, and simplifying access to care, DPC empowers business owners to provide a benefit that truly works for their team and their bottom line.  👉 Ready to explore Direct Primary Care for your small business? Contact Free Range Direct Primary Care today to learn how we can help you save money while keeping your employees healthier and happier.

How Direct Primary Care and Concierge Medicine Can Help Prevent Chronic Disease Chronic diseases such as diabetes, hypertension, heart disease, and obesity are the leading causes of death and disability in the United States. According to the Centers for Disease Control and Prevention (CDC), six in ten American adults have at least one chronic disease, and four in ten have two or more (CDC, 2023). These conditions are largely preventable through lifestyle interventions, early detection, and consistent medical management. Innovative healthcare models such as Direct Primary Care (DPC) and Concierge Medicine are uniquely positioned to address these challenges and improve long-term health outcomes. What Are Direct Primary Care and Concierge Medicine? Direct Primary Care (DPC) : Patients pay a flat monthly or annual fee for unlimited access to their primary care physician. This model eliminates the traditional insurance middleman, reducing administrative burden and allowing physicians to focus more on patient care. Concierge Medicine : Similar to DPC, but typically involves higher membership fees and may still bill insurance. Patients benefit from enhanced access, same-day appointments, extended visits, and a strong physician-patient relationship. Both models share a focus on accessibility, prevention, and continuity of care . How DPC and Concierge Medicine Help Prevent Chronic Disease 1. More Time with Patients Traditional primary care visits average about 15 minutes (Tseng et al., 2018). In contrast, DPC and concierge visits often last 30–60 minutes, giving physicians more time to address risk factors such as diet, exercise, stress, and sleep. Longer visits foster shared decision-making and patient engagement, both of which are linked to better health outcomes (Barry & Edgman-Levitan, 2012). 2. Better Access and Continuity of Care Chronic disease prevention relies on early detection and consistent monitoring. DPC and concierge patients often enjoy same- or next-day appointments, direct messaging with their physician, and more frequent follow-ups. Evidence shows that improved continuity of care reduces hospitalizations and emergency visits (Barker et al., 2017). 3. Focus on Preventive Screenings Physicians in these models have fewer patients—often 600–800 in concierge care and 400–600 in DPC, compared to 2,000+ in traditional practices (Alexander et al., 2021). With smaller panels, physicians can ensure patients stay up-to-date with cancer screenings, vaccinations, and lab monitoring, all of which are crucial for preventing chronic disease. 4. Lifestyle and Behavior Change Support Preventing chronic disease requires addressing lifestyle risk factors. With more time and stronger relationships, DPC and concierge physicians can provide personalized coaching on nutrition, physical activity, and stress management. Studies suggest that physician counseling can significantly increase adherence to healthy behaviors (US Preventive Services Task Force, 2020). 5. Reduced Administrative Burden In traditional models, physicians spend nearly half their day on electronic health records and paperwork (Sinsky et al., 2016). By reducing billing complexity, DPC and concierge practices free up physician time, enabling more focus on preventive and patient-centered care. Evidence of Impact A study in Health Affairs found that patients in practices emphasizing continuity of care had lower rates of hospital admissions and emergency department visits (Barker et al., 2017). Research published in Annals of Internal Medicine shows that intensive lifestyle counseling can reduce the incidence of type 2 diabetes by up to 58% (Knowler et al., 2002). Practices with smaller patient panels are more likely to meet preventive care quality benchmarks, such as cancer screenings and hypertension control (Alexander et al., 2021). Conclusion Direct Primary Care and Concierge Medicine models offer a promising path forward in the fight against chronic disease. By prioritizing time, access, continuity, and preventive care, these models empower patients and physicians alike to focus on what truly matters— long-term health and disease prevention . As healthcare continues to evolve, embracing innovative approaches like DPC and concierge care may be key to reducing the burden of chronic disease in America.  References Alexander, G. C., Kurlander, J., & Wynia, M. K. (2021). Physicians in concierge and direct primary care. Journal of General Internal Medicine, 36(1), 272–275. Barker, I., Steventon, A., & Deeny, S. R. (2017). Association between continuity of care in general practice and hospital admissions for ambulatory care sensitive conditions: Cross sectional study of routinely collected, person level data. BMJ, 356, j84. Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making—pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780–781. CDC. (2023). Chronic diseases in America. Retrieved from https://www.cdc.gov/chronicdisease/ Knowler, W. C., et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6), 393–403. Sinsky, C., et al. (2016). Allocation of physician time in ambulatory practice: A time and motion study in 4 specialties. Annals of Internal Medicine, 165(11), 753–760. Tseng, P., et al. (2018). Trends in total time spent with patients in primary care. BMC Health Services Research, 18, 559. US Preventive Services Task Force (USPSTF). (2020). Behavioral counseling interventions to promote a healthy lifestyle in adults. Retrieved from https://www.uspreventiveservicestaskforce.org/

Welcome to The PEAK! The PEAK, or “Patient Education And Knowledge,” is the monthly newsletter for Free Range Direct Primary Care. This newsletter will hopefully provide you with evidence-based medical knowledge as well as updates regarding the practice. Practice Updates NEW PATIENTS: I am continuing to accepting new patients! Currently, I can see them in 1-2 days for a new patient appointment. If you know of anyone in need of a primary care doctor, please send them my way! REVIEWS: I would love if you can provide a 5-star Google review for my practice! You may do so by visiting here, https://g.page/r/CXhfHK-SrDl6EBM/review . Please let me know if I can improve on anything. Thank you! APPOINTMENTS: If you are in need of an appointment, please schedule here . You may also call or email and I can get you on the schedule. MEDICATION REFILLS: Please text/call (434-337-5934) or email ( drjohnson@frdpc.com ) with medication refill requests. I will get them to your pharmacy as soon as possible. ‍ November November is Lung Cancer Awareness Month! In this issue we discuss: Current Lung Cancer Screening Guidelines Smoking Cessation Guidelines Tips on Preparing for Cold and Flu Season Predicting Direct Primary Care Evolution Lung Cancer Screening Lung Cancer Screening: The United States Preventive Services Task Force (USPSTF) recommends annual lung cancer screening with low-dose computed tomography (LDCT) for adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. The American Cancer Society (ACS) aligns with these recommendations, emphasizing the importance of shared decision-making and the elimination of the years-since-quit (YSQ) criterion for beginning or ending screening. Lung Cancer Screening. Choi HK, Mazzone PJ. The Medical Clinics of North America. 2022;106(6):1041-1053. doi:10.1016/j.mcna.2022.07.007. Screening for Lung Cancer: US Preventive Services Task Force Recommendation Statement. Krist AH, Davidson KW, Mangione CM, et al.Jama. 2021;325(10):962-970. doi:10.1001/jama.2021.1117. Screening for Lung Cancer: 2023 Guideline Update From the American Cancer Society. Wolf AMD, Oeffinger KC, Shih TY, et al.CA: A Cancer Journal for Clinicians. 2024 Jan-Feb;74(1):50-81. doi:10.3322/caac.21811. Smoking Cessation The National Comprehensive Cancer Network (NCCN) recommends a multimodal approach to smoking cessation, which includes evidence-based motivational strategies and behavior therapy (counseling), pharmacotherapy, and close follow-up with retreatment as needed. The two most effective pharmacotherapies are combination nicotine replacement therapy (NRT) and varenicline. The American College of Chest Physicians and the American Thoracic Society also emphasize integrating smoking cessation efforts into LDCT screening programs, recommending interventions such as nicotine replacement therapy, bupropion, and varenicline, along with behavioral counseling. ‍ Smoking Cessation, Version 3.2022, NCCN Clinical Practice Guidelines in Oncology. Shields PG, Bierut L, Arenberg D, et al. Journal of the National Comprehensive Cancer Network : JNCCN. 2023;21(3):297-322. doi:10.6004/jnccn.2023.0013. An Official American Thoracic Society/­American College of Chest Physicians Policy Statement: Implementation of Low-Dose Computed Tomography Lung Cancer Screening Programs in Clinical Practice. Wiener RS, Gould MK, Arenberg DA, et al. American Journal of Respiratory and Critical Care Medicine. 2015;192(7):881-91. doi:10.1164/rccm.201508-1671ST. Pairing Smoking-Cessation Services With Lung Cancer Screening: A Clinical Guideline From the Association for the Treatment of Tobacco Use and Dependence and the Society for Research on Nicotine and Tobacco. Fucito LM, Czabafy S, Hendricks PS, et al. Cancer. 2016;122(8):1150-9. doi:10.1002/cncr.29926. ‍ Tips For The Upcoming Cold & Flu Season To prepare for the cold and flu season, several evidence-based strategies can be employed: Vaccination: The Advisory Committee on Immunization Practices (ACIP) recommends annual influenza vaccination for all individuals aged 6 months and older who do not have contraindications. Vaccination should ideally occur before the onset of flu activity, typically by the end of October. We have these available in our office. Just contact Dr. Johnson to schedule for your vaccination. Preventive Behaviors: According to Srivastav et al., preventive behaviors such as frequent hand washing, covering coughs and sneezes, staying home when sick, and avoiding close contact with sick individuals are crucial. These behaviors help reduce the transmission of influenza and other respiratory viruses. Nonpharmaceutical Interventions: During the COVID-19 pandemic, measures such as mask-wearing, physical distancing, and enhanced hygiene practices significantly reduced the transmission of respiratory viruses, including influenza. These interventions can be effective during the flu season as well. Nutritional Support: Rondanelli et al. highlight the role of vitamins and minerals in supporting immune function. Regular supplementation with vitamin C (1-2 g/day) and zinc can reduce the duration and severity of cold symptoms. Vitamin D supplementation is also beneficial, particularly for individuals with deficiency. Antiviral Medications: For those who contract influenza, early initiation of antiviral medications, such as oseltamivir, can reduce the duration of symptoms and the risk of complications. These should be started within 48 hours of symptom onset. Environmental Hygiene: Regular cleaning and disinfecting of frequently touched surfaces can help prevent the spread of viruses. Ensuring good ventilation in indoor spaces is also recommended. In summary, vaccination, preventive behaviors, non-pharmaceutical interventions, nutritional support, antiviral medications, and environmental hygiene are key strategies to prepare for and mitigate the impact of the cold and flu season. ‍ Prevention and Control of Seasonal Influenza With Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2022-23 Influenza Season. Grohskopf LA, Blanton LH, Ferdinands JM, et al. MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports. 2022;71(1):1-28. doi:10.15585/mmwr.rr7101a1. Copyright License: CC0 Preventive Behaviors Adults Report Using to Avoid Catching or Spreading Influenza, United States, 2015-16 Influenza Season. Srivastav A, Santibanez TA, Lu PJ, et al. PloS One. 2018;13(3):e0195085. doi:10.1371/journal.pone.0195085. Decreased Influenza Activity During the COVID-19 Pandemic - United States, Australia, Chile, and South Africa, 2020. Olsen SJ, Azziz-Baumgartner E, Budd AP, et al. MMWR. Morbidity and Mortality Weekly Report. 2020;69(37):1305-1309. doi:10.15585/mmwr.mm6937a6. Changes in Influenza and Other Respiratory Virus Activity During the COVID-19 Pandemic - United States, 2020-2021. Olsen SJ, Winn AK, Budd AP, et al. MMWR. Morbidity and Mortality Weekly Report. 2021;70(29):1013-1019. doi:10.15585/mmwr.mm7029a1. Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved During an Episode of Common Colds-Practical Advice on Dosages and on the Time to Take These Nutrients/­Botanicals in Order to Prevent or Treat Common Colds. Rondanelli M, Miccono A, Lamburghini S, et al. Evidence-Based Complementary and Alternative Medicine : eCAM. 2018;2018:5813095. doi:10.1155/2018/5813095. Clinical Practice Guidelines by the Infectious Diseases Society of America: 2018 Update on Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management of Seasonal Influenzaa. Uyeki TM, Bernstein HH, Bradley JS, et al. Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America. 2019;68(6):895-902. doi:10.1093/cid/ciy874. ‍ Predicting Direct Primary Care Evolution: A New Dawn for Healthcare By: Nick Soman - Decent Introduction to Direct Primary Care Defining Direct Primary Care and Its Significance in the Healthcare Industry Direct Primary Care (DPC) represents a paradigm shift in healthcare delivery, redefining the patient-provider relationship. This model, where patients pay a fixed monthly fee directly to their primary care provider, excludes the complexities of traditional insurance billing. Its significance lies in its simplicity and patient-centered approach, offering more time for patient care, reduced administrative burdens, and an emphasis on preventative health. Contrasting Direct Primary Care with Traditional Healthcare Models In contrast to the traditional fee-for-service model, which often leads to brief, infrequent patient interactions, DPC fosters an environment where physicians can spend more time with each patient. This allows for comprehensive care, focusing not only on immediate medical issues but also on long-term health planning. The traditional model, often constrained by insurance company policies, can limit the time and scope of care a physician can provide. The Growing Popularity of Direct Primary Care The rise in popularity of Direct Primary Care is a response to growing patient and physician dissatisfaction with the standard healthcare model. Patients are attracted to the transparency, accessibility, and personalized care DPC offers, while physicians appreciate the autonomy and the ability to practice medicine more aligned with their original intent – caring for patients without undue external pressures. The Evolution of Direct Primary Care Historical Development of Direct Primary Care Direct Primary Care began as a grassroots movement in the early 2000s, with physicians seeking an alternative to the high-pressure, high-volume constraints of traditional practice. Initially adopted by a small but passionate group of practitioners, it has since gained momentum, attracting attention as a viable alternative to traditional healthcare delivery. Major Milestones in Direct Primary Care Key milestones in DPC's evolution include the establishment of the Direct Primary Care Coalition, which has played a significant role in advocating for DPC at the policy level, and the growing body of research highlighting DPC's positive impacts on patient health outcomes and satisfaction. Innovations such as integrating electronic health records (EHRs) and telemedicine have also been crucial in expanding DPC’s reach and capabilities. Technology's Role in Direct Primary Care's Growth Technology has been a catalyst in DPC's evolution. Telehealth, for instance, has expanded the reach of DPC physicians, allowing them to offer care remotely. EHRs have streamlined patient data management, making it easier for DPC practices to track patient health outcomes and tailor care to individual needs. Impact of Legislation and Policy on Direct Primary Care Healthcare Policies Influencing Direct Primary Care Healthcare policies at both the federal and state levels have had a significant impact on the growth of DPC. For example, states that have passed legislation recognizing DPC as a non-insurance healthcare model have provided a legal framework for its operation, encouraging more physicians to adopt this model. Policy Shifts and Their Effects on Direct Primary Care Policy shifts like the IRS ruling that allowed Health Savings Accounts (HSAs) to be used for DPC fees have made this model more accessible to a broader population. Conversely, policies that categorize DPC as a form of insurance have created hurdles, limiting its adoption in certain regions. Predicting the Future of Direct Primary Care Forecasting Methods for Direct Primary Care's Evolution Predictive analytics, market trend analyses, and policy trend monitoring are methods used to forecast the future of DPC. These approaches help in understanding how changes in healthcare demand, technology, and legislation might shape the future of DPC. Emerging Trends in Direct Primary Care Future trends in DPC may include an increased focus on integrated care models, where DPC practices work closely with specialists to provide comprehensive care. Another potential trend is the expansion of DPC into more holistic care, encompassing mental health, nutrition, and wellness services. The Influence of Medical Advancements on DPC Advancements in personalized medicine, like genetic testing and tailored treatment plans, are likely to be incorporated into DPC practices. This evolution could lead to even more personalized care plans, improving patient outcomes and satisfaction.  Challenges and Opportunities in Direct Primary Care Potential Obstacles for Direct Primary Care Challenges for DPC include misconceptions about its model, varying state laws, and ensuring affordability. Additionally, as DPC grows, maintaining the high level of personalized care that defines the model could become more challenging. Opportunities Stemming from Direct Primary Care Growth Opportunities for DPC include potential reductions in overall healthcare costs and improvements in chronic disease management. For physicians, DPC offers a more satisfying practice environment, potentially reducing burnout. For patients, the model promises more accessible, personalized care. Conclusion: The Promising Future of Direct Primary Care Direct Primary Care stands at the cusp of revolutionizing healthcare delivery. By focusing on patient-centered care, leveraging advancements in technology, and adapting to changes in healthcare policy and demand, DPC is poised to play a pivotal role in shaping the future of healthcare. This model’s emphasis on preventative care, chronic disease management, and personalized patient experiences positions it as a sustainable, effective solution to many of the challenges facing today's healthcare system. Addressing Specific Questions While predicting patient preferences for end-of-life care can be challenging, DPC’s model of extended patient interactions could lead to better understanding and more accurate predictions of patient wishes. Direct Primary Care has been gaining momentum since the early 2000s, emerging as a response to the challenges of traditional healthcare models. Future changes in healthcare likely include an increased focus on models like DPC that prioritize strong patient-provider relationships and integrate advanced technology and personalized care approaches. The Direct Primary Care model is characterized by a direct financial relationship between patients and providers, bypassing traditional insurance, and focusing on accessible, personalized primary care. Direct Primary Care represents not just an alternative to traditional healthcare but a reimagining of the patient-doctor relationship. Its continued evolution and adoption are a testament to its potential to offer more humane, effective, and patient-centered healthcare. As the healthcare landscape continues to evolve, DPC stands as a beacon of innovation and patient advocacy, heralding a new era in healthcare delivery.

Welcome to The PEAK! The PEAK, or “Patient Education And Knowledge,” is the monthly newsletter for Free Range Direct Primary Care. This newsletter will hopefully provide you with evidence-based medical knowledge as well as updates regarding the practice. Practice Updates NEW PATIENTS: I am continuing to accepting new patients! Currently, I can see them in 1-2 days for a new patient appointment. If you know of anyone in need of a primary care doctor, please send them my way! REVIEWS: I would love if you can provide a 5-star Google review for my practice! You may do so by visiting here, https://g.page/r/CXhfHK-SrDl6EAE/review . Please let me know if I can improve on anything. Thank you! APPOINTMENTS: If you are in need of an appointment, please schedule here . You may also call or email and I can get you on the schedule. MEDICATION REFILLS: Please text/call (434-337-5934) or email ( drjohnson@frdpc.com ) with medication refill requests. I will get them to your pharmacy as soon as possible. In this issue… Common fall allergens and how to best combat them? October is National Breast Cancer Awareness Month Fall is Open Enrollment Season - Where Does DPC Fit In? Common Fall Allergens And How To Best Combat Them Common fall allergens include ragweed pollen , mold spores , and dust mites . Effective management of these allergens involves a combination of pharmacologic and non-pharmacologic strategies. Below are some simple things you can do to help you better enjoy your fall outside without pesky allergens. Intranasal corticosteroids are the first-line treatment for allergic rhinitis due to their superior efficacy in reducing inflammation and symptoms. The American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) strongly recommends these agents for patients whose symptoms affect their quality of life. Examples include fluticasone, triamcinolone, and budesonide. [1] Oral second-generation antihistamines are recommended for patients with primary complaints of sneezing and itching. These agents, such as cetirizine, fexofenadine, and loratadine, are effective and have a lower risk of sedation compared to first-generation antihistamines. [1] Combination therapy with intranasal corticosteroids and intranasal antihistamines (e.g., azelastine) can be considered for patients with inadequate response to monotherapy. This approach has been shown to provide greater symptomatic relief. [2] Immunotherapy is an option for patients who do not respond adequately to pharmacologic therapy. Both subcutaneous and sublingual immunotherapy can be effective, particularly for those with specific allergen sensitivities confirmed by IgE testing. [2] Environmental controls are also crucial. The Joint Task Force on Practice Parameters (American Academy of Allergy, Asthma & Immunology, American College of Allergy, Asthma and Immunology, Joint Council of Allergy, Asthma and Immunology) suggests measures such as using air filtration systems, bed covers, and acaricides to reduce indoor allergen exposure. Additionally, staying indoors during high pollen counts, using air conditioning with HEPA filters, and keeping windows closed can help limit exposure to outdoor allergens. [2] These strategies, grounded in clinical guidelines and evidence, provide a comprehensive approach to managing fall allergies effectively. References Clinical Practice Guideline: Allergic Rhinitis. Seidman MD, Gurgel RK, Lin SY, et al. Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery. 2015;152(1 Suppl):S1-43. doi:10.1177/0194599814561600. Rhinitis 2020: A practice Parameter Update. Dykewicz MS, Wallace DV, Amrol DJ, et al. The Journal of Allergy and Clinical Immunology. 2020;146(4):721-767. doi:10.1016/j.jaci.2020.07.007. https://www.givelively.org/updates/four-nonprofits-in-honor-of-breast-cancer-awareness-month October is National Breast Cancer Awareness Month The key to reducing morbidity and mortality from breast cancer is early detection. Understanding the recommendations for screening are crucial but can be confusing. It is important to talk about this with you doctor so that you can make the best decision for your health. The current breast cancer screening guidelines vary among different organizations, reflecting differences in the balance of benefits and harms of screening, as well as the importance of shared decision-making. The American College of Physicians (ACP) recommends that average-risk women aged 50 to 74 years undergo biennial mammography. For women aged 40 to 49 years, the ACP suggests that the decision to start screening should be individualized based on patient preferences and values, given the close balance between benefits and harms in this age group. The American Cancer Society (ACS) recommends that women aged 45 to 54 years should undergo annual mammography, while women aged 55 years and older should transition to biennial screening, with the option to continue annual screening. Women aged 40 to 44 years should have the choice to start annual mammography. The U.S. Preventive Services Task Force (USPSTF) recommends biennial screening mammography for women aged 50 to 74 years. For women aged 40 to 49 years, the decision to start biennial screening should be individualized, taking into account the patient's values regarding the potential benefits and harms. The World Health Organization (WHO) recommends mammography screening for women aged 50 to 69 years, emphasizing the importance of shared decision-making. For women aged 40 to 49 years, WHO suggests screening only in the context of rigorous research and shared decision-making strategies. The Canadian Task Force on Preventive Health Care (CTFPHC) conditionally recommends against routine screening for women aged 40 to 49 years without a first-degree family history of breast cancer, but acknowledges that some women may wish to be screened and advises shared decision-making in these cases. For women aged 50 to 69 years, biennial screening is recommended. These guidelines highlight the importance of individualized decision-making, particularly for women in their 40s, and reflect a consensus that biennial screening is appropriate for women aged 50 to 74 years. American College of Physicians Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians Published April 2019 In addition to the guidelines previously mentioned, the American College of Radiology (ACR) recommends annual mammography starting at age 40 for average-risk women, emphasizing that this approach saves the most lives by detecting cancer early. The American College of Obstetricians and Gynecologists (ACOG) also supports offering mammography starting at age 40, with a strong emphasis on shared decision-making to tailor screening to individual patient preferences and risk factors. The National Comprehensive Cancer Network (NCCN) advises annual mammography beginning at age 40 for average-risk women, aligning closely with the ACR and ACOG recommendations. The World Health Organization (WHO) suggests mammography screening for women aged 50 to 69 years, with a focus on shared decision-making for women aged 40 to 49 years, similar to the USPSTF guidelines. The Canadian Task Force on Preventive Health Care (CTFPHC) conditionally recommends against routine screening for women aged 40 to 49 years without a first-degree family history of breast cancer, but advises biennial screening for women aged 50 to 69 years. This recommendation underscores the importance of individualized decision-making for younger women. Overall, while there is a consensus on the benefits of mammography for women aged 50 to 74 years, recommendations for women in their 40s vary, highlighting the need for personalized screening strategies based on patient values and risk factors. References Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians. Qaseem A, Lin JS, Mustafa RA, et al. Annals of Internal Medicine. 2019;170(8):547-560. doi:10.7326/M18-2147. Harmonizing Breast Cancer Screening Recommendations: Metrics and Accountability. Lee CS, Moy L, Friedewald SM, Sickles EA, Monticciolo DL. AJR. American Journal of Roentgenology. 2018;210(2):241-245. doi:10.2214/AJR.17.18704. Screening for HIV Infection: US Preventive Services Task Force Recommendation Statement . Owens DK, Davidson KW, Krist AH, et al. Jama. 2019;321(23):2326-2336. doi:10.1001/jama.2019.6587. Informed Choices: How DPC Compares to Insurance in Open Enrollment Season By: Rachel Rombough of Direct Primary Care of Burleson (adapted) Traditional health insurance programs currently offer open enrollment for patients. During this special enrollment period, you can enroll for 2025 health coverage without a qualifying life event, such as loss of coverage or marriage. Many people believe that they can only receive affordable healthcare services with insurance coverage, however, direct primary care serves as a fantastic alternative. This guide explains what direct primary care is, how it compares to traditional insurance, and everything you should consider before making a decision. What Is Direct Primary Care? Direct primary care, or DPC, eliminates the need for third-party insurance companies. Patients will instead pay a premium, either as a monthly or annual fee, directly to the healthcare provider. In exchange, they can receive the following services: Urgent care services Physical wellness exams Chronic disease management Allergy testing Women's health services In-office procedures Patients can receive treatment for a majority of common ailments through a DPC provider. Unfortunately it excludes any emergency medical care or surgery. DPC vs. Insurance If you're reluctant to renew your insurance coverage or change plans during open enrollment, you could find that switching to DPC better suits your needs. The key differences come down to the total cost but also the coverage. You need to determine which program checks off all the boxes for you. Pros and Cons of Insurance When you carry health insurance, you hold a contract with a provider. In exchange for a monthly premium, your policy covers everything from preventative care and prescription drugs to hospitalizations and surgeries. However, the structure of modern health insurance comes with several drawbacks. The monthly payments might not fit your budget, and you'll have to either wait for the next open enrollment or endure a qualifying life event to change your policy. You may not be able to see your doctor when you get sick or injured due to limited availability. Pros and Cons of DPC With direct primary care, you can receive coverage on a contract basis. Your membership fee tends to be more predictable than insurance and since payment goes directly to your doctor, there are less administrative hassles. There are no surprise bills and you get personalized care. Another pro to DPC is that it is accessible and you can have direct access to your provider and cut out the middle man hassles of insurance. You don’t need to wait for answers or worry about not feeling heard. One notable drawback is that DPC doesn't usually include coverage for hospital stays or surgeries. How to Make the Right Decision for You Choosing direct primary care over traditional insurance appeals to a growing number of Americans. However, the decision ultimately comes down to your needs. Do you have a serious medical condition that frequently puts you in the hospital? Insurance supplemented with DPC that includes this type of care might be a better option. On the other hand if you benefit from preventative care and routine care, DPC is a great option.  Free Range Direct Primary Care – Providing Superior Care to Charlottesville, VA If you don't have insurance coverage, there's no need to wait for open enrollment to see a provider. Free Range Direct Primary Care treats a range of common conditions and can keep you healthy with affordable, personalized services. Contact our clinic in Charlottesville, VA at (434) 337-5934 to learn more about becoming a member or to schedule an appointment.

Welcome to The PEAK! The PEAK, or “Patient Education And Knowledge,” is the monthly newsletter for Free Range Direct Primary Care. This newsletter will hopefully provide you with evidence-based medical knowledge as well as updates regarding the practice.  Practice Updates NEW PATIENTS: My office is accepting new patients! Currently, I can see them in 1-2 days for a new patient appointment. If you know of anyone in need of a primary care doctor, please send them my way! APPOINTMENTS: If you are in need of an appointment, please schedule here . You may also call or email and I can get you on the schedule. MEDICATION REFILLS: Please text/call (434-337-5934) or email ( drjohnson@frdpc.com ) with medication refill requests. I will get them to your pharmacy as soon as possible. In this issue… What are the warning signs of diabetes? Supplements: What does the evidence say? September is “Healthy Aging” Month

Welcome to The PEAK! The PEAK, or “Patient Education And Knowledge,” is the monthly newsletter for Free Range Direct Primary Care. This newsletter will hopefully provide you with evidence-based medical knowledge as well as updates regarding the practice. Practice Updates School Physicals: If the kids are in need of school physicals prior to starting school. Let me know! I can get them in for a visit. NEW PATIENTS: My office is accepting new patients! Currently, I can see them in 1-2 days for a new patient appointment. If you know of anyone in need of a primary care doctor, please send them my way! APPOINTMENTS: If you are in need of an appointment, please schedule here . You may also call or email and I can get you on the schedule. MEDICATION REFILLS: Please text/call (434-337-5934) or email ( drjohnson@frdpc.com ) with medication refill requests. I will get them to your pharmacy as soon as possible. In this issue… Standard of Care for Hypertension Bioidentical Hormones: What does the evidence say? What are the benefits of Direct Primary Care?

What are the risks and benefits of statin medications? Statin medications, or HMG-CoA reductase inhibitors, are widely used for the primary and secondary prevention of cardiovascular diseases (CVD). The benefits and risks of statin therapy are well-documented in the medical literature. Benefits: Reduction in Cardiovascular Events: Statins significantly reduce the risk of myocardial infarction, ischemic stroke, and other atherosclerotic events. For instance, statin therapy can reduce the risk of major vascular events by about one-quarter for each mmol/L reduction in LDL cholesterol. Mortality Reduction: Statins are associated with a decrease in all-cause mortality and cardiovascular mortality, particularly in high-risk populations. Pleiotropic Effects: Statins also offer benefits beyond lipid-lowering, such as improved endothelial function, anti-inflammatory properties, and stabilization of atherosclerotic plaques. Risks: Muscle-Related Symptoms: Statin-associated muscle symptoms (SAMS), including myopathy and rhabdomyolysis, are rare but significant. The risk of serious muscle injury, such as rhabdomyolysis, is less than 0.1%. Diabetes Mellitus: Statin therapy is associated with a small increased risk of new-onset diabetes, particularly with high-intensity statin therapy. Liver Toxicity: Asymptomatic increases in liver transaminases are noted, but serious hepatotoxicity is rare (≈0.001%). Other Potential Risks: There is a possible increased risk of hemorrhagic stroke in patients with cerebrovascular disease, although the overall stroke risk reduction is greater. There is no convincing evidence linking statins to cancer, cognitive dysfunction, or cataracts. The American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines recommend statins for four major benefit groups, emphasizing that the cardiovascular benefits outweigh the risks in these populations. The US Preventive Services Task Force (USPSTF) also supports the use of statins for primary prevention in adults aged 40 to 75 years with one or more CVD risk factors. In summary, while statins are associated with some risks, their benefits in reducing cardiovascular events and mortality generally outweigh these risks in appropriately selected patients. References Interpretation of the Evidence for the Efficacy and Safety of Statin Therapy. Collins R, Reith C, Emberson J, et al. Lancet (London, England). 2016;388(10059):2532-2561. doi:10.1016/S0140-6736(16)31357-5. Statins for Prevention of Cardiovascular Disease in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force. Chou R, Dana T, Blazina I, Daeges M, Jeanne TL. Jama. 2016;316(19):2008-2024. doi:10.1001/jama.2015.15629. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. Chou R, Cantor A, Dana T, et al. Jama. 2022;328(8):754-771. doi:10.1001/jama.2022.12138. Potential Benefits and Risks Associated With the Use of Statins. Khatiwada N, Hong Z. Pharmaceutics. 2024;16(2):214. doi:10.3390/pharmaceutics16020214. Statin Safety and Associated Adverse Events: A Scientific Statement From the American Heart Association. Newman CB, Preiss D, Tobert JA, et al. Arteriosclerosis, Thrombosis, and Vascular Biology. 2019;39(2):e38-e81. doi:10.1161/ATV.0000000000000073. The Safety of Statins in Clinical Practice. Armitage J. Lancet (London, England). 2007;370(9601):1781-90. doi:10.1016/S0140-6736(07)60716-8. 2013 ACC/­AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/­American Heart Association Task Force on Practice Guidelines. Stone NJ, Robinson JG, Lichtenstein AH, et al. Journal of the American College of Cardiology. 2014;63(25 Pt B):2889-934. doi:10.1016/j.jacc.2013.11.002.  Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement. Bibbins-Domingo K, Grossman DC, Curry SJ, et al. Jama. 2016;316(19):1997-2007. doi:10.1001/jama.2016.15450. Contact Free Range Direct Primary Care today to learn more about how Direct Primary Care can benefit you and your family. Your journey to better health starts here. Call/Text: (434) 337-5934 Email: drjohnson@frdpc.com Website: www.frdpc.com Disclaimer: This blog post is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding any medical questions or concerns.

Important screening tests for adults are guided by evidence-based recommendations from various professional societies. Here are key screening tests: Hypertension : The U.S. Preventive Services Task Force (USPSTF) recommends screening for hypertension in adults aged 18 years or older with office blood pressure measurement. Annual screening is suggested for adults aged 40 years or older and those at increased risk, while screening every 3-5 years is appropriate for younger adults with normal blood pressure and no risk factors. Colorectal Cancer : The USPSTF recommends screening for colorectal cancer starting at age 50 and continuing until age 75. Screening methods include annual fecal occult blood testing, fecal immunochemical testing, sigmoidoscopy every 5 years, or colonoscopy every 10 years. Lipid Disorders : The American College of Cardiology (ACC) and American Heart Association (AHA) recommend lipid screening for adults aged 40-75 years to assess cardiovascular risk and guide statin therapy. Diabetes Mellitus : The USPSTF recommends screening for type 2 diabetes in adults aged 40-70 years who are overweight or obese. Screening should be done with fasting plasma glucose, HbA1c, or an oral glucose tolerance test. Abdominal Aortic Aneurysm : The USPSTF recommends one-time screening with ultrasonography for men aged 65-75 years who have ever smoked. Lung Cancer : The USPSTF recommends annual screening with low-dose computed tomography for adults aged 55-80 years with a 30 pack-year smoking history who currently smoke or have quit within the past 15 years. Prostate Cancer : The USPSTF recommends against routine prostate-specific antigen (PSA) screening for prostate cancer, but suggests individualized decision-making for men aged 55-69 years. Hepatitis B Virus (HBV) : The Centers for Disease Control and Prevention (CDC) recommends at least once-lifetime screening for HBV in adults aged ≥18 years. HIV and Sexually Transmitted Infections (STIs) : Routine screening for HIV is recommended for all adults aged 15-65 years, and for other STIs based on risk factors. Immunizations : Immunizations should be updated according to the guidelines from the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC). These recommendations are based on the latest evidence and guidelines from authoritative bodies such as the USPSTF, ACC, AHA, and ACIP. References Screening for Hypertension in Adults: US Preventive Services Task Force Reaffirmation Recommendation Statement. Krist AH, Davidson KW, Mangione CM, et al. Jama. 2021;325(16):1650-1656. doi:10.1001/jama.2021.4987. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. Davidson KW, Barry MJ, Mangione CM, et al. Jama. 2021;325(19):1965-1977. doi:10.1001/jama.2021.6238. 2019 AHA/ACC Clinical Performance and Quality Measures for Adults With High Blood Pressure: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Casey DE, Thomas RJ, Bhalla V, et al. Circulation. Cardiovascular Quality and Outcomes. 2019;12(11):e000057. doi:10.1161/HCQ.0000000000000057. The Adult Well Male Examination. Heidelbaugh JJ, Tortorello M. American Family Physician. 2012;85(10):964-71. The Adult Well-Male Examination. Heidelbaugh JJ. American Family Physician. 2018;98(12):729-737. Screening for Cancer: Concepts and Controversies. Gates TJ. American Family Physician. 2014;90(9):625-31. Screening and Testing for Hepatitis B Virus Infection: CDC Recommendations - United States, 2023. Conners EE, Panagiotakopoulos L, Hofmeister MG, et al. MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports. 2023;72(1):1-25. doi:10.15585/mmwr.rr7201a1. Copyright License: CC0 Sexually Transmitted Infections Treatment Guidelines, 2021. Workowski KA, Bachmann LH, Chan PA, et al. MMWR. Recommendations and Reports : Morbidity and Mortality Weekly Report. Recommendations and Reports. 2021;70(4):1-187. doi:10.15585/mmwr.rr7004a1. Contact Free Range Direct Primary Care today to learn more about how Direct Primary Care can benefit you and your family. Your journey to better health starts here. Call/Text: (434) 337-5934 Email: drjohnson@frdpc.com Website: www.frdpc.com Disclaimer: This blog post is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding any medical questions or concerns.

The Importance of Routine Preventative Medical Visits: Ensuring Your Health and Wellness In today's fast-paced world, prioritizing our health often takes a back seat to our hectic schedules and daily demands. However, maintaining regular preventative medical visits is crucial for safeguarding our well-being in the long run. Whether you're seeking a primary care physician or looking to establish a reliable healthcare routine, understanding the significance of these visits can significantly impact your overall health. Why Choose Direct Primary Care? Direct primary care (DPC) practices, such as Free Range Direct Primary Care in Charlottesville, Virginia, offer a unique approach to healthcare that focuses on personalized attention and accessibility. Unlike traditional healthcare models, DPC eliminates the barriers of insurance bureaucracy by offering memberships that cover comprehensive primary care services. This means you have direct access to your doctor without the hassle of copays or insurance claims. They also cover many in-office procedures and screenings as well. The Role of Primary Care Physicians Your primary care physician plays a pivotal role in managing your health and preventing potential medical issues. From routine check-ups and vaccinations to managing chronic conditions, they serve as your first point of contact for all health-related concerns. Establishing a relationship with a primary care provider near you ensures that you have someone who understands your medical history and can provide personalized recommendations for your well-being. Scheduling Your Appointment Making an appointment with a primary care doctor should not be a daunting task. Our practice offers easy access to our schedule that allows you to self-schedule online without having to wait on the phone to speak with someone. Of course, if you prefer to call, text or email, we can get you on the schedule that way as well. Whether you're due for a check-up or have specific health concerns, scheduling your appointment ensures that you stay proactive about your health. We want that to be as simple and straightforward as possible. Promoting Health and Wellness Routine preventative visits are not just about addressing current health issues but also about identifying potential risks early on. Through regular screenings and health assessments, your doctor can detect conditions such as high blood pressure, diabetes, or cancer in their early stages when they are more treatable. This proactive approach not only saves lives but also reduces healthcare costs in the long term. Membership Benefits and Accessible Care Joining a DPC practice such as Free Range Direct Primary Care in Charlottesville provides several advantages, including extended appointment times, same-day or next-day visits for urgent matters, and enhanced continuity of care. Membership models often include services like annual physical exams, chronic disease management, and nutritional counseling, promoting holistic health and wellness. Dr. Johnson also does many in-office procedures which do not require you to be referred elsewhere and wait weeks to months to be seen. Conclusion Prioritizing routine preventative medical visits is a vital investment in your health. Whether you're exploring primary care options near you in Charlottesville or considering the benefits of direct primary care, taking proactive steps toward regular check-ups can significantly impact your overall well-being. By establishing a relationship with a primary care physician and embracing a preventative care mindset, you're not just managing current health concerns but also safeguarding your future health and quality of life. If you're in Charlottesville, Virginia, and looking for a practice that is accepting new patients and emphasizes personalized care, consider exploring Free Range Direct Primary care. Your health is your most valuable asset—take the first step toward a healthier tomorrow today! Contact Free Range Direct Primary Care today to learn more about how Direct Primary Care can benefit you and your family. Your journey to better health starts here. Call/Text: (434) 337-5934 Email: drjohnson@frdpc.com Website: www.frdpc.com Disclaimer: This blog post is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding any medical questions or concerns.