Frankly Speaking About Family Medicine

Flexibility in Treatment: What Yoga Can Offer Patients with Knee Osteoarthritis - Frankly Speaking Ep 480

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-480
Overview: Tune in as we discuss nonsurgical options for managing knee osteoarthritis in primary care. This episode reviews current guidelines and highlights new research on yoga as an effective alternative to traditional strengthening exercises. Gain practical insights to help patients reduce pain, improve function, and delay surgery—all while expanding your integrative treatment toolkit.
Episode resource links:
Abafita BJ, Singh A, Aitken D, et al. Yoga or strengthening exercise for knee osteoarthritis: a randomized clinical trial. JAMA Netw Open. 2025;8(4):e253698. doi:10.1001/jamanetworkopen.2025.3698
Brophy, Robert H. MD; Fillingham, Yale A. MD. AAOS Clinical Practice Guideline Summary: Management of Osteoarthritis of the Knee (Nonarthroplasty), Third Edition. Journal of the American Academy of Orthopaedic Surgeons 30(9):p e721-e729, May 1, 2022. | DOI: 10.5435/JAAOS-D-21-01233
Guest: Jillian Joseph, MPAS, PA-C
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Can an ARB Help Prevent Migraine Attacks? - Frankly Speaking Ep 479

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-479
Overview: Listen in as we discuss how candesartan, an angiotensin receptor blocker (ARB), may offer a well-tolerated, cost-effective option for migraine attack prevention—even in normotensive patients. Learn to assess benefits, monitor for hypotension, and expand your preventive migraine toolkit with evidence-based insights that may improve adherence and access for patients struggling with traditional therapies.
Episode resource links:
The Lancet. Neurology. 2025;24(10):817-827. doi:10.1016/S1474-4422(25)00269-8.
Cephalalgia : An International Journal of Headache. 2023;43(6):3331024231183166. doi:10.1177/03331024231183166.
Guest: Robert A. Baldor MD, FAAFP Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

GLP-1 RAs and Hair Loss—Evaluating and Managing a Potential Side Effect - Frankly Speaking Ep 478

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-478
Overview: As glucagon-like peptide-1 receptor agonists (GLP-1 RAs) become increasingly common in managing obesity, it is important for clinicians to recognize lesser-known adverse effects. This episode highlights the potential link between GLP-1 RAs and alopecia, equipping you to better evaluate, counsel, and manage patients reporting hair loss.
Episode resource links:
Alsuwailem OA, Alanazi R, Almutairi HM, Asiree RH, Almutairi W, Almutairi TM, Zamandar A, Alkhames S. Hair Loss Associated With Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Use: A Systematic Review. Cureus. 2025 Sep 16;17(9):e92454. 
Guest: Alan M. Ehrlich, MD, FAAFP Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

AI Scribing in Practice: Balancing Patient Considerations and Clinician Wellbeing - Frankly Speaking Ep 477

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-477
Overview: With rising administrative demands, many clinicians are considering artificial intelligence (AI) scribes—this episode unpacks what you need to know before incorporating this technology. We explore key benefits like reduced burnout and improved workflow, along with ethical, legal, and safety considerations to help you make informed decisions about integrating AI scribing into your practice.
Episode resource links:
Cohen IG, Ritzman J, Cahill RF. Ambient Listening—Legal and Ethical Issues. JAMA Netw Open.2025;8(2):e2460642. doi:10.1001/jamanetworkopen.2024.60642
Olson KD, Meeker D, Troup M, et al. Use of Ambient AI Scribes to Reduce Administrative Burden and Professional Burnout. JAMA Netw Open. 2025;8(10):e2534976. doi:10.1001/jamanetworkopen.2025.34976
https://www.healio.com/news/dermatology/20251210/ai-scribes-hold-transformative-potential-for-improving-physician-burden-patient-care
Guest: Jillian Joseph, MPAS, PA-C Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Melatonin: Is a “Natural” Sleep Aid as Harmless as We Think? - Frankly Speaking Ep 476

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-476
Overview: Melatonin is widely used and often perceived as a safe, natural solution for insomnia. However, a new preliminary study raises concerns about long-term melatonin use and increased risk of heart failure, hospitalization, and all-cause mortality in patients with chronic insomnia. In this episode, we review the findings, discuss how they fit with existing evidence, explore limitations, and offer practical guidance for clinicians counseling patients about sleep supplements.
Episode resource links:
American Heart Association Scientific Sessions 2025 – Abstract 4371606AHA Scientific Statement: Multidimensional Sleep Health and Cardiometabolic Risk (Circulation, 2025)
Li et al. Lancet Diabetes & Endocrinology, 2024
American Academy of Sleep Medicine Clinical Practice Guidelines
AHA Life’s Essential 8 & Sleep Health Resources
Guest: Mariyan Montaque, DNP, FNP-BC Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

New Complaint? Wait! Could It Be a Medication Side Effect? - Frankly Speaking Ep 475

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-475
Overview: A prescribing cascade occurs when adverse effects of a medication are mistaken for a new condition and treated with additional drugs. Older adults experiencing polypharmacy are most at risk. The impact of prescribing cascades can be substantial, leading to falls, organ injury, unnecessary imaging and tests, and more. Join us as we explore how to recognize and prevent these harmful cascades in your patients.
Episode resource links:
Adrien  O, Mohammad  AK, Hugtenburg  JG,  et al.  Prescribing cascades with recommendations to prevent or reverse them: a systematic review.   Drugs Aging. 2023;40(12):1085-1100. doi:10.1007/s40266-023-01072-yPubMedGoogle ScholarCrossref
 
Brath  H, Mehta  N, Savage  RD,  et al.  What is known about preventing, detecting, and reversing prescribing cascades: a scoping review.   J Am Geriatr Soc. 2018;66(11):2079-2085. doi:10.1111/jgs.15543PubMedGoogle ScholarCrossref
 
Daunt R, McGettigan S, Kelly L, Curtin D, O'Mahony D. Detection of Potential Prescribing Cascades in Multimorbid Older Patients Hospitalised with Acute Illness-An Observational Prospective Prevalence Study. Drugs Aging. 2025;42(6):535-546. doi:10.1007/s40266-025-01201-9
 
Growdon ME, Tjota N, Campbell R, et al. Decision-Making and Downstream Outcomes of the Gabapentinoid-Diuretic Prescribing Cascade. JAMA Netw Open. 2025;8(12):e2545274. doi:10.1001/jamanetworkopen.2025.45274
 
McCarthy  LM, Savage  R, Dalton  K,  et al.  ThinkCascades: a tool for identifying clinically important prescribing cascades affecting older people.   Drugs Aging. 2022;39(10):829-840. doi:10.1007/s40266-022-00964-9PubMedGoogle ScholarCrossref
 
O’Mahony, D., Cherubini, A., Guiteras, A.R. et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med 14, 625–632 (2023). https://doi.org/10.1007/s41999-023-00777-y
 
Rochon, P.A., O’Mahony, D., Cherubini, A. et al. International expert panel’s potentially inappropriate prescribing cascades (PIPC) list. Eur Geriatr Med 16, 1573–1584 (2025). https://doi.org/10.1007/s41999-025-01215-x
 
Young EH, Pan S, Yap AG, Reveles KR, Bhakta K. Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016. PLoS One. 2021;16(8):e0255642. Published 2021 Aug 3. doi:10.1371/journal.pone.0255642
Guest: Susan Feeney, DNP, FNP-BC, NP-C Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Does Treating Depression Worsen Dementia? - Frankly Speaking Ep 474

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-474
Overview: Depression affects many people with dementia, but some evidence suggests certain antidepressants may accelerate cognitive decline. This episode explores the potential risks of antidepressants in people with dementia, which medications require careful consideration, and how to make informed prescribing decisions that optimize patient outcomes while minimizing potential cognitive harm.
Episode resource links:
Mo M, Abzhandadze T, Hoang MT, et al. Antidepressant use and cognitive decline in patients with dementia: a national cohort study. BMC Med. 2025;23(1):82. 
Guest: Alan M. Ehrlich, MD, FAAFP
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Does PSA Testing for Prostate Cancer Save Lives? - Frankly Speaking Ep 473

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-473
Overview: Join us as we review long-term outcomes from a recently published trial on prostate-specific antigen (PSA) testing and prostate cancer mortality. Learn how updated evidence informs shared decision-making and balances early detection with potential harms. Equip yourself to guide patients through nuanced discussions on PSA testing’s limitations, mortality data, and meaningful clinical impact.
Episode resource links:
N Engl J Med 2025;393:1669-80. DOI: 10.1056/NEJMoa2503223
Recommendation: Prostate Cancer: Screening | United States Preventive Services Taskforce
Guest: Robert A. Baldor MD, FAAFP
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Hospital to Home: Optimizing Follow-Up After Discharge - Frankly Speaking Ep 472

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-472
Overview: The transition from hospital to home is a valuable period for patients and clinicians. In this episode, we discuss which patients require follow-up, what should be reviewed during these appointments, and when follow-up should take place to help improve patient outcomes.
Episode resource links:
Anderson, T. S., Herzig, S. J., Marcantonio, E. R., Yeh, R. W., Souza, J., & Landon, B. E. (2024, April). Medicare transitional care management program and changes in timely postdischarge follow-up. In JAMA Health Forum (Vol. 5, No. 4, pp. e240417-e240417). American Medical Association.
Anderson, T. S., Wilson, L. M., Wang, B. X., Steinman, M. A., Schonberg, M. A., Marcantonio, E. R., & Herzig, S. J. (2025). Medication Errors and Gaps in Medication Discharge Planning for Hospitalized Older Adults: A Prospective Cohort Study. Journal of general internal medicine, 1-10.
 
Balasubramanian, I., Andres, E. B., & Malhotra, C. (2025). Outpatient follow-up and 30-day readmissions: a systematic review and meta-analysis. JAMA Network Open, 8(11), e2541272-e2541272.
Guest: Mariyan L. Montaque, DNP, FNP-BC
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Weekend Warrior or Daily Mover? Exercise Counseling for Patients with Diabetes - Frankly Speaking Ep 471

Credits: 0.25 AMA PRA Category 1 Credit™ CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-471
Overview: Discover how flexible physical activity patterns can reduce mortality and cardiovascular risk in patients with diabetes. This episode translates evidence on “weekend warrior” vs regular exercise into practical counseling strategies, empowering you to help time-constrained patients achieve the mortality benefits of weekly moderate-to-vigorous physical activity—regardless of scheduling pattern.
Episode resource links:
Wu, Z., Sheng, C., Guo, Z., Zheng, Y., Zheng, D., Li, X., Guo, X., & Li, H. (2025). Association of Weekend Warrior and Other Physical Activity Patterns With Mortality Among Adults With Diabetes : A Cohort Study. Annals of internal medicine, 178(9), 1279–1286. https://doi.org/10.7326/ANNALS-25-00640
Guest: Jill M. Terrien PhD, ANP-BC 
Music Credit: Matthew Bugos
Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com 
The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.