How Primary Care Is Being Disrupted: A Video Primer
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How patients are seeing their doctor is changing, and that could shape access to and quality of care for decades to come.
More than 100 million Americans don’t have regular access to primary care, a number that has nearly doubled since 2014. Yet demand for primary care is up, spurred partly by record enrollment in Affordable Care Act plans. Under pressure from increased demand, consolidation, and changing patient expectations, the model of care no longer means visiting the same doctor for decades.
KFF Health News senior correspondent Julie Appleby breaks down what is happening — and what it means for patients.
More From This Investigation
Primary Care Disrupted
Known as the “front door” to the health system, primary care is changing. Under pressure from increased demand, consolidation, and changing patient expectations, the model of care no longer means visiting the same doctor for decades. KFF Health News looks at what this means for patients.
Credits
Hannah Norman Video producer and animator Oona Tempest Illustrator and creative director KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Darwin’s Bed Rest: Worthwhile Idea?
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I recall that Charles Darwin (of Evolution fame) used to spend a day a month in bed in order to maintain his physical and psychological equilibrium. Do you see merit in the idea?❞
Well, it certainly sounds wonderful! Granted, it may depend on what you do in bed :p
Descartes did a lot of his work from bed (and also a surprising amount of it while hiding in an oven, but that’s another story), which was probably not so good for the health.
As for Darwin, his health was terrible in quite a lot of ways, so he may not be a great model.
However! Certainly taking a break is well-established as an important and healthful practice:
How To Rest More Efficiently (Yes, Really)
❝I don’t like to admit it but I am getting old. Recently, I had my first “fall” (ominous word!) I was walking across some wet decking and, before I knew what had happened, my feet were shooting forwards, and I crashed to the ground. Luckily I wasn’t seriously damaged. But I was wondering whether you can give us some advice about how best to fall. Maybe there are some good videos on the subject? I would like to be able to practice falling so that it doesn’t come as such a shock when it happens!❞
This writer has totally done the same! You might like our recent main feature on the topic:
…if you’ll pardon the pun
Enjoy!
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Hardcore Self Help: F**k Anxiety – by Dr. Robert Duff
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We’ve reviewed other anxiety books before, so what makes this one different? Mostly, it’s the style.
Aside from swearing approximately once every two lines (so you might want to skip this one if that would bother you), Dr. Duff’s writing is very down-to-earth in other ways too, making it unpretentiously comfortable and accessible without failing to draw upon the wealth of good-practice, evidence-based advice he has to offer.
To that end, he talks about what anxiety is and isn’t, and goes over various approaches, explaining them in a “about” fashion, and also a “how to” fashion, covering areas such as CBT, somatic therapies, social support, when talk therapy is most likely to help.
The book is a quick read (a modest 74 pages), and it’s refreshing that it hasn’t been padded unnecessarily, unlike a lot of books that could have been a fraction of the size without losing value.
Bottom line: if you (or perhaps someone you care about) would benefit from a straight-to-the-point, no-BS approach to dealing with anxiety (that’s actually evidence-based, not just a “get over it” dismissal), then this is the book for you.
Click here to check out Hardcore Self Help: F**k Anxiety, and indeed do just that!
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Cavolo Nero & Sweet Potato Hash
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🎶 Sweet potato hash? It’s a seasonal smash… Catches on in a flash… Let’s do the hash 🎶
You will need
- 6 oz cavolo nero, tough stems removed, chopped
- 1 large sweet potato, diced
- 1 large red onion, finely chopped
- 1 parsnip, grated
- 1 small red pepper, chopped
- 4 oz baby portobello mushrooms, chopped
- ½ cup fresh or thawed peas
- ¼ bulb garlic, thinly sliced
- 1 tbsp nutritional yeast
- 2 tsp black pepper, coarse ground
- 1 tsp dried rosemary
- 1 tsp dried thyme (dried for convenience; fresh is also fine if you have it)
- 1 tsp red chili flakes (dried for convenience; fresh is also fine if you have it)
- 1 tsp ground turmeric
- ½ tsp MSG or 1 tsp low-sodium salt
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 425℉ / 220℃.
2) Toss the diced sweet potato in 1 tbsp olive oil, as well as the nutritional yeast, ground turmeric, black pepper, and MSG/salt, ensuring an even distribution. Roast in the oven on a lined baking tray, for 30 minutes, turning at least once to get all sides of the potato. When it is done, remove from the oven and set aside.
3) Heat a little oil in a sauté pan or large skillet (either is fine; we’re not adding liquids today), and fry the onion, parsnip, and pepper until softened, which should take about 5 minutes (this is one reason why we grated the parsnip; the other is for the variation in texture).
4) Add the garlic, mushrooms, herbs, and chili flakes, and cook for a further 1 minute, while stirring.
5) Add the cavolo nero and peas, stir until the cavolo nero begins to wilt, and then…
6) Add the roasted sweet potato; cook for about 5 more minutes, pressing down with the spatula here and there to mash the ingredients together.
7) Turn the hash over when it begins to brown on the bottom, to lightly brown the other side too.
8) Serve hot.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Brain Food? The Eyes Have It!
- Which Bell Peppers To Pick?
- Ergothioneine: “The Longevity Vitamin” (That’s Not A Vitamin)
- Our Top 5 Spices: How Much Is Enough For Benefits?
- What’s Your Plant Diversity Score?
Take care!
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The Truth About Statins – by Barbara H. Roberts, M.D.
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All too often, doctors looking to dispense a “quick fix” will prescribe from their playbook of a dozen or so “this will get you out of my office” drugs. Most commonly, things that treat symptoms rather than the cause. Sometimes, this can be fine! For example, in some cases, painkillers and antidepressants can make a big improvement to people’s lives. What about statins, though?
Prescribed to lower cholesterol, they broadly do exactly that. However…
Dr. Roberts wants us to know that we could be missing the big picture of heart health, and making a potentially fatal mistake.
This is not to say that the book argues that statins are necessarily terrible, or that they don’t have their place. Just, we need to understand what they will and won’t do, and make an informed choice.
To which end, she does advise regards when statins can help the most, and when they may not help at all. She also covers the questions to ask if your doctor wants to prescribe them. And—all so frequently overlooked—the important differences between men’s and women’s heart health, and the implications these have for the efficacy (or not) of statins.
With regard to the “alternatives to cholesterol-lowering drugs” promised in the subtitle… we won’t keep any secrets here:
Dr. Roberts (uncontroversially) recommends the Mediterranean diet. She also provides two weeks’ worth of recipes for such, in the final part of the book.
All in all, an important book to read if you or a loved one are taking, or thinking of taking, statins.
Pick up your copy of The Truth About Statins on Amazon today!
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Oats vs Pearl Barley – Which is Healthier?
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Our Verdict
When comparing oats to pearl barley, we picked the oats.
Why?
In terms of macronutrients first, pearl barley has about three times the carbs for only the same amount of protein and fiber—if it had been regular barley rather than pearl parley, it’d have about twice the fiber, but pearl barley has had the fibrous husk removed.
Vitamins really set the two part, though: oats have a lot more (60x more) vitamin A, and notably more of vitamins B1, B2, B3, B5, B6, and B9, as well as 6x more vitamin E. In contrast, pearl barley has a little more vitamin K and choline. An easy win for oats in this section.
In the category of minerals, oats have over 6x more calcium, 3x more iron, and a little more magnesium, manganese, and phosphorus. Meanwhile, pearl barley boats a little more copper, potassium, selenium, and zinc. So, a more moderate win for oats in this category.
They are both very good for the gut, unless you have a gluten intolerance/allergy, in which case, oats are the only answer here since pearl barley, as per barley in general, has gluten as its main protein (oats, meanwhile, do not contain gluten, unless by cross-contamination).
Adding up all the sections, this one’s a clear win for oats.
Want to learn more?
You might like to read:
- Eat More (Of This) For Lower Blood Pressure
- Making Friends With Your Gut (You Can Thank Us Later)
- Gluten: What’s The Truth?
Take care!
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Salmon vs Tuna – Which is Healthier?
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Our Verdict
When comparing salmon to tuna, we picked the tuna.
Why?
It’s close, and there are merits and drawbacks to both!
In terms of macros, tuna is higher in protein, while salmon is higher in fats. How healthy are the fats, you ask? Well, it’s a mix, because while there are plenty of “good” fats in salmon, salmon is also 10x higher in saturated fat and 150% higher in cholesterol.
So when it comes to fats, if you want to eat fish and have the healthiest fats, one option is to skip the salmon, and instead serve tuna with some extra virgin olive oil.
We’ll call this section a clear win for tuna.
On the vitamin front, they are close to equal. Salmon has more of some vitamins, tuna has more of others; all in all we’d say the balance is in salmon’s favor, but by the time a portion of salmon is giving you 350% of your daily requirement, does it really matter that the same portion of tuna is “only” giving you 294% of the daily requirement? It goes like that for a lot of the vitamins they both contain.
Still, we’ll call this section a nominal win for salmon.
In the category of minerals, tuna is much higher in iron while salmon is higher in calcium. The rest of the minerals they both have, tuna is comfortably higher—and since the “% of RDA in a portion” figures are double-digit here rather than triple, those margins are relevant this time.
We’ll call this section a moderate win for tuna.
Both fish carry a risk of mercury poisoning, but this varies more by location than by fish, so it hasn’t been a consideration in this head-to-head.
Totting up the sections, this a modest but clear win for tuna.
Want to learn more?
You might like to read:
Farmed Fish vs Wild-Caught: Important Differences!
Take care!
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