Osteopathic Family Physician Journal

In a digital world where misinformation spreads faster than the truth, osteopathic family medicine has never been more essential. As the trusted first point of contact, primary care physicians are often the only consistent voice guiding patients through the noise. Whether it’s social media–fueled ...

This article is designed to be distributed as a PDF. To share with your patients, please download the PDF. Sjögren’s syndrome is an autoimmune disease in which your body’s immune system mistakenly attacks healthy glands of the eyes and mouth. This syndrome can occur independently, or with other...

WHY IS VITAMIN K IMPORTANT IN NEWBORNS? Vitamin K is a fat-soluble vitamin essential for blood clotting. Newborns have naturally low levels of vitamin K, increasing their risk for vitamin K deficiency bleeding (VKDB). 1,2 Without supplementation, it can take up to 6 months for newborn...

The field of skincare has been rapidly evolving, making it harder to navigate the plethora of products and trends. Vitamin C, topical retinoids, and sunscreen effectively prevent and combat the effects of photoaging with sunscreen being the most crucial product for daily use. Daily application of a ...

Past iterations of the Diabetes Prevention Program (DPP) have demonstrated success in reducingthe risk of developing type 2 diabetes in high-risk individuals, including studies that focused onlow-carbohydrate or ketogenic approaches. The program emphasizes dietary modifications,phy...

This article was designed to be viewed and distributed as a PDF. Please download the PDF for easiest reading. WHAT IS VAPING? Vaping is the act of inhaling aerosols from battery-powered devices called electronic cigarettes, also known as vape...

To the OFP Editor: Student Doctors Anna-Taylor Harbin and Alexa Lane provided a useful overview of human papillomavirus in the OFP Patient Education Handout (published in the Fall 2024 issue). They also raised some important questions concerning HPV for family physicians. Which HPV-relat...

Verruca vulgaris, known as common warts, is rough, thickened growths on the skin caused by human papillomavirus (HPV). The infection is most prevalent in children but does affect people of all ages. 1 Common warts are most frequently found on the hands and feet but can appear anywhere on the bod...

For a printable version to share with your patients, please download the PDF. This handout provides essential information about childhood cancers, including types, causes, symptoms, diagnosis, treatment options, and prevention. TYPES OF CHILDHOOD CANCERS The most common types of cancers that ...

BACKGROUND Carpal tunnel syndrome (CTS) is one of the most common nerve disorders, affecting approximately 3%-6% of adults in the United States, with a higher prevalence among women and individuals in certain occupations, such as office work. 1 It occurs when the median nerve is compressed within...

INTRODUCTION Acne vulgaris is one of the most common skin conditions, affecting an estimated 50 million people in the United States each year. Typical acne develops when hair follicles become clogged with excess oil, dead skin cells, and sometimes bacteria, leading to inflammation. ...

For a printable version to share with your patients, please download the PDF. MAP 1. High-risk regions for contracting travelers’ diarrhea Map 1 created by authors using Microsoft Excel. WHAT IS TRAVELERS’ DIARRHEA? Travelers’ diarrhea is a condition related to the ingestio...

A 5-year-old presented to urgent care with a 3-day history of fever with a tympanic Tmax of 102°F. Laboratory studies revealed positive results for Influenza B and negative for COVID. Physical examination revealed a left erythematous tympanic membrane with bulging and decreased motion. The patient w...

Medicine is challenging. Added to this are the struggles our patients face on a day-to-day basis. They have been exposed to situations that were unthinkable or not common 20 years ago. Some of these situations have changed, for better or worse, due to societal problems. In 2012, the Centers fo...

Summer is the traditional time for family reunions, but as we transition to fall, we may spend more time at work and with another form of family: our professional colleagues. During my presidential address at ACOFP ‘25 in Palm Springs, we gathered a word cloud based on the responses ...

For a printable version to share with your patients, please download the PDF. If there was a way to protect yourself from the most common cancer in the United States, would you do it?Knowledge about skin cancer and its prevention is one of the most powerful tools to protect yourself from it. Th...

Download the PDF to view the full-scale timeline of ACOFP's history, including many of the "firsts" that made ACOFP what it is today. Published in honor of ACOFP's 75th anniversary. ...

This article was designed to be viewed and distributed as a PDF. Please download the PDF for easiest reading. WHAT IS SEASONAL AFFECTIVE DISORDER (SAD)? SAD is a seasonal pattern of major depressive disorder, bipolar I disorder, or bipolar II diso...

WHAT IS “SAFE SLEEP”? Safe sleep means creating a sleeping space for your baby that reduces the risk of sudden unexpected infant death (SUID), which includes sudden infant death syndrome (SIDS), and accidental suffocation during sleep. These events usually happen during sleep and are...

This article was designed to be viewed and distributed as a PDF. Please download the PDF for easiest reading. WHAT IS A ROTATOR CUFF? A rotator cuff is a group of muscles and tendons that hold the arm in the shoulder socket and allow the arm to ...

Coccydynia is characterized by pain or discomfort in the coccyx region, most frequently caused bydirect trauma. This condition, exacerbated by sitting on flat or hard surfaces, may cause immobility andadversely impact activities of daily living. Standard treatment options include ergonom...

Renal cell carcinoma (RCC) is the most common type of renal cancer, and it is usually found incidentallyin asymptomatic individuals. Despite an increase in prevalence, RCC mortality has improved.Advancements have been made over the years in diagnostic and treatment modalities and screeni...

Infants are born with low levels of vitamin K, placing them at risk for vitamin K deficiency bleeding (VKDB). To prevent this, the American Academy of Pediatrics recommends intramuscular (IM) vitamin K for all newborns. However, parental refusal of this and other standard newborn interventions is in...

As we move through the summer months, we’re reminded that while the seasons change, the demands of medicine rarely slow. In recent months, we’ve continued to see the practice of medicine, and the science that underpins it, challenged in the public sphere. Yet, as osteopathic family physicians, we r...

This lesion was followed at the patient’s subsequent 2-month well- child check and is depicted in Figure 2, with gradual changes noted in the lesion. Figure 3 shows the continuation of hyperpigmentation and verrucous transformation of the skin lesion at the 4-month well-child check. The pa...

Statins are the drug of choice to help lower cholesterol levels. Adverse effects, although infrequent, are usually linked to dose increases and improve with medication reduction/cessation. The growing population of patients prescribed statin medications and the nature of their use for lifetime car...

As we approach the close of another year, it is important to reflect on the challenges and progress we have made in our profession. The year’s final months often prompt us to think about personal and professional renewal and how we can better serve our patients, colleagues, and communities in the y...

As we progress in 2025, I am privileged to share my reflections in this special edition of the Osteopathic Family Physician . This issue marks the 75th anniversary of the American College of Osteopathic Family Physicians (ACOFP), a significant milestone that celebrates our enduring legacy and cal...

As we settle back into routine after the holidays, the decorations come down and the familiar rhythm of daily practice returns. Still, winter offers a moment to reflect on the year behind us, the accomplishments achieved, the challenges navigated, and the resilience built along the way. It is also...

Objective:Provide clinical recommendations to help patients engage in type 2 diabetes mellitus (T2DM) self-careMethods: Review current literature to understand patient engagement (PE) and utilize case examples to demonstrate PE in common scenarios regarding diabetes self-care.Results: T2DM is ...

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This article is designed to be distributed to patients. For easy printing, please download the PDF. WHAT IS OSTEOPOROSIS? Osteoporosis is a condition in which bones become thinner, weaker, and are more likely to break. Osteoporosis is called a “silent” disease because there are typically no s...

Depression and anxiety symptoms have a profound impact on a person’s life, affecting their emotional well-being, relationships, and overall quality of life long-term. This case study presents a patient who suffered from persistent neck pain, depression, and anxiety for 9 months following a traumatic...

Pelvic girdle pain (PGP) during and after pregnancy can present diagnostic and therapeutic challenges. In our case, a 31-year-old Asian American woman developed PGP and lower back pain that was not relieved 3 months’ postpartum. She was treated with over-the-counter analgesics and physical therapy f...

Hip pain and disorders are commonly seen in adults and children in the primary care setting. Primary care physicians can manage many of these disorders through physical examinations and basic radiographs, but some may pose a challenge requiring advanced imaging and specialist interventio...

Chronic noncancer pain presents a significant challenge worldwide, particularly among the elderly population, where concerns of polypharmacy and additional morbidity and mortality risks exist. When nonopioid treatment approaches are deemed ineffective, the decision to use opioids requires a careful ...

Background: This collaboration from the Obesity Medicine Association (OMA) and ACOFP examines obesity management from a primary care perspective.Methods: This joint perspective is based on scientific evidence, clinical experience of the authors, and peer review by OMA and ACOFP leadership. The goal ...

CASE PRESENTATION A 17-day-old male infant, born at 39 weeks and 3 days’ gestation via spontaneous vaginal delivery, was admitted to the pediatric inpatient service for worsening skin rash over the past 5 days. The patient’s mother states that the rash started as scattered erythematous papul...

This article is designed to be distributed to patients. For easy printing, please download the PDF. Kidney stones, medically known as nephrolithiasis, are characterized by the formation of hard mineral deposits in the kidneys or urinary tract 1 (Figure 1). These stones can range in size...

This article is designed to be viewed and distributed as a PDF. Please download the PDF for easiest reading. What Is Masculinizing GAHT? Masculinizing gender-affirming hormone therapy (GAHT) is the use of hormones to develop masculine physical attributes. The individual must ha...

Polycystic ovary syndrome (PCOS), endometriosis, and uterine fibroids are highly prevalent gynecologic conditions that often lead to pelvic pain, menstrual irregularities, and infertility. While standard treatment relies on hormonal therapy and surgery, there is growing interest in integrative, nonp...

Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) are common throughout the world and cause a great deal of morbidity and mortality. Acute exacerbations can result in missed work, hospitalizations, and sometimes death. This review will discuss the epidemiol...

Binge eating disorder (BED) is a mental health condition characterized by recurrent episodes of consuming large amounts of food, in the absence of the compensatory behaviors seen in bulimia nervosa. Patients with BED often first present to primary care physicians (PCPs), who play a pivotal role in d...

Colitis is an inflammatory condition of the colon commonly associated with inflammatory bowel disease (IBD). However, non-IBD colitis can also present similarly, often resulting from medications or ischemia leading to chronic symptoms as well as diagnostic challenges. The literature on non-IBD colit...

Ehlers-Danlos syndrome (EDS) encompasses a group of hereditary connective tissue disorders characterized by abnormal collagen structure and function. Common comorbid conditions include mast cell activation syndrome, dysautonomia, and cardiovascular abnormalities. This paper examines potential benefi...

This edition of OFP focuses on topics of interest to readers, including the childhood obesity epidemic, the care of transgender patients, and the treatment of trigger finger. All are important to the physician of today. The osteopathic profession and family osteopathic physicians are far richer...

Osteopathic family physicians embody the philosophy of whole-person care, including using a biopsychosocial approach to incorporate mental health into patient care. The creation of the Behavioral Health Integration Collaborative increased support for a system-level adoption of whole-pers...

Introduction: Stenosing tenosynovitis of the flexor tendon, more commonly known as trigger finger (TF), is an ailment characterized by inflammation of the A1 pulley. This inflammation can eventually lead to pain and the inability to manipulate the digit. While surgical release is considered the gold...

Case Report A 2-year-old male with history of episodic eczema presented to the emergency department following multiple episodes of emesis throughout the morning. The mother estimated that the patient had 5-10 episodes of nonbloody, nonbilious, mucus-predominant emesis. The mother also endorsed 1 d...

Human parechovirus (HPeV) infections have been increasing in the United States since May 2022, according to the Centers for Disease Control and Prevention. HPeVs are a member of the Picornaviridae family and share similarities with enteroviruses, though they differ in genomic structure. ...

This article is designed to be distributed to patients. For easiest printing, please download the PDF. Human papillomavirus (HPV) refers to a single virus with numerous subtypes that can be spread between sexual partners through skin-to-skin contact, sexual activity (including vaginal, a...

According to the CDC, as of July 2023, almost 25 million Americans have asthma. Inhaled medications will likely be used at some point as part of their therapy. Asthma medications come in many delivery devices, including metered-dose inhalers (MDIs, also called HFAs [hydrofluoroalkane], a type of p...

Histiocytic sarcoma is a rare and frequently missed diagnosis. With unusual and varied presentations, it typically indicates a rapid patient decline and poor outcomes. The diagnosis requires a high degree of clinical suspicion. In this case, we explore the progression of illness in a 56-...

For a printable version to share with your patients, please download the PDF. WHAT DOES BLOOD PRESSURE MEASURE? Blood pressure measures the force with which blood pushes against the arteries. Arteries carry blood from the heart to the rest of the body. When your blood pressure is high, it mea...

As we enter the winter season, a time of holidays, family, friends, and togetherness, we’re reminded of both the joys and the challenges this time of year brings. For many, it’s a season filled with wonderful memories. For family physicians, it’s also a time when waiting rooms are full and respirat...

Introduction: Food and nutrition insecurity, characterized by limited or uncertain access to sufficient and affordable nutritious foods, is an economic and social condition at the individual, household, and neighborhood levels that poses a significant public health issue. Health impacts of food inse...

This month’s issue of OFP is themed around women’s health and newborn health, topics that in many ways could not be more timely. In a time of growing misinformation in American health care, osteopathic family physicians are more essential than ever. As trusted clinicians rooted in whole...

Correction 1/13/2026: The print version of this article and the original PDF versions included minor errors in the lettering of the answer choices for questions 1 and 3. CASE REPORT An 18-year-old patient presented to her primary care doctor with a circular rash on the left lateral hip....

In the current environment, patients are inundated by health information and misinformation from an excess of sources. It is harder than ever to know what institutions to trust, and to discern what differentiates research from rumor. As doctors, our first priority is the health of ...

Background: Smoking is the most important preventable cause of adverse outcomes in pregnancy;however, most smokers who become pregnant continue to smoke and/or relapse following delivery.The identification of patients at risk can be challenging, and the treatment options available can benebulous, in...

Physicians in all areas may face isolation and loneliness, with many showing signs of burnout and emotional exhaustion. We are connected to the physician and insurance networks by our computers and often work late hours, perhaps rushing home to an event for our families. Meetings with peers and o...

Chronic venous insufficiency is a common condition categorized by ever-increasing incidence, prevalence, and recurrence, despite treatment. Older individuals (adults 65 years of age and older) are most affected in terms of diagnosis and severity. Guidelines discussed include disease characterization...

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that primarily affects the joints. The condition causes inflammation, pain, stiffness, and sometimes deformity in the affected joints. RA can also affect other parts of the body, including the lungs, heart, and eyes, and it can lead to long-...

Primary care physicians are crucial in diagnosing and managing hand and wrist pain. As the first point of contact for patients, primary care physicians develop individualized treatment plans, which may involve prescribing medications, recommending physical therapy, providing joint inject...

Sleep is crucial for normal, healthy development in childhood. Consistent, high-quality sleep regimens lead to better overall health outcomes, such as enhanced focus, behavior, learning, memory, emotional control, and overall mental and physical well-being. In contrast, poor, minimal, and irregular ...

This article is designed to be viewed and distributed as a PDF. Please download the PDF for easiest reading. WHAT IS COLORECTAL CANCER? Colorectal cancer is a form of cancer that affects the colon and/or rectum. Early detection of this cancer can be challenging as it does not typically present ...

Colorectal cancer is a leading cause of morbidity and mortality in the United States. Family physicians play an integral role in educating patients about the current screening recommendations and modalities of available screening to improve early detection and allow treatment at its earl...

Chronic pelvic pain (CPP) is a debilitating condition that significantly impacts the quality of life of females. It is defined as pelvic pain lasting at least 6 months or longer, and stems from multiple etiologies, including gynecologic, gastrointestinal, urologic, musculoskeletal, neurologic, and p...

Chronic limb-threatening ischemia (CLTI) is an advanced form of peripheral vascular disease with high rates of morbidity and mortality. Patients often present with claudication, impaired walking, and ischemic pain. Screening for CLTI and peripheral arterial disease is recommended with an...

Rates of obesity among adults and children in the United States have been on the rise for decades and continue to increase based on recent studies. This is due to a combination of individual, environmental, and socioeconomic factors. Most recent studies indicate that 19.7%, or approximately 14.7 mil...

Dear Members, As I embark on my role as President, I am excited and deeply honored to guide us along a strategic path to fortify our profession and our impact together. This critical juncture provides a compelling chance to invigorate our collective initiatives and redefine the future of osteopath...

The annual rate of cervical cancer death has been in slow decline in part due to the broad implementation of screening technology. This annual death rate is also affected by risk factor exposure and discovery of new treatments. While the current rate, 2.2 deaths in 100,000 women, is the lowest recor...

This article was designed to be viewed and distributed as a PDF. Please download the PDF for easiest reading WHAT IS PAP SMEAR SCREENING FOR? The Papanicolaou test, otherwise known as a “Pap test” or “Pap smear,” is used to screen for cervical cancer. WHY IS IT IMPORTANT TO SCREEN FOR CERVIC...

There is no better feeling of accomplishment than when a student matches into a desired residency program! This milestone means that students, faculty, administration, and staff have achieved a monumental task. All their planning, strategies, and work have culminated in that one special word: “Ma...

This article is designed to be viewed and distributed as a PDF. Please download the PDF for easiest reading. Sleep apnea is a common sleep disorder characterized by pauses in breathing during sleep. These pauses can last from seconds to minutes and can occur multiple times throughout the nigh...

Ovarian cancer is the second most common type of cancer affecting the female reproductive system. Ovaries are important organs in the female body responsible for producing eggs and hormones like estrogen and progesterone. EARLY SIGNS/SYMPTOMS AND RISK FACTORS Recognizing the early s...

Individuals who identify as transgender (TGD) who are taking gender-affirming hormone therapies (GAHT) may experience physiologic changes that impact the interpretation of laboratory results, diagnostic tools, and risk calculations. This review provides guidance for healthcare practitioners on navig...

What's Normal? All boys are born with a protective layer of skin to cover the end of their penis. This is known as the foreskin. This layer of skin is present at birth and provides protection from rubbing and infection. It is natural for the foreskin to be tightly stuck to the end of the penis. Th...

Fibromyalgia (FM) is a prevalent condition characterized by widespread musculoskeletal pain, often accompanied by fatigue, cognitive difficulties, mental health symptoms, sleep problems, and various other physical complaints. Current research refers to FM as dysfunction of pain processing in the cen...

Correction: Updated Breast Cancer Screening Guidelines Patient Education HandoutWe thank our readers for identifying that the previously published Patient Education Handout (PEH) for Breast Cancer Screening Guidelines contained outdated standards of care.The relevant guidelines were updated after th...

Correction: Updated Breast Cancer Screening Guidelines Patient Education HandoutWe thank our readers for identifying that this Patient Education Handout (PEH) for Breast Cancer Screening Guidelines contained outdated standards of care.The relevant guidelines were updated after the PEH’s accept...

INTRODUCTION Mastitis is a general term used to describe the array of inflammatory conditions affecting the breast. It presents a significant clinical challenge, especially in distinguishing cases requiring pharmacologic or surgical intervention from those manageable with supportive care a...

Acute kidney injury (AKI) is commonly caused by medications including, but not limited to, aminoglycosides, cephalosporins, penicillins, trimethoprim-sulfamethoxazole, and amphotericin. Among pediatric patients, clindamycin has been widely used to treat skin and soft-tissue infections, abscesses, os...

Hair loss impacts both physical appearance and psychosocial well-being. It necessitates a compassionate and comprehensive approach to diagnosis and treatment. This narrative review presents current evidence on the most common nonscarring alopecias, i.e. androgenetic alopecia (AGA), alopecia areata (...

Many osteopathic textbooks include treatment modalities and techniques that could improve frequently experienced ailments of pregnancy, such as nausea, vomiting, gastroesophageal reflux disease, constipation, and edema. However, there is little scientific evidence to support the use of o...

Amiodarone is the most used anti-arrhythmic drug worldwide.1 Its effectiveness for the treatment of multiple arrhythmias including atrial fibrillation, supraventricular tachycardia, and ventricular tachycardia is well documented.2 Older adults, however, are especially prone to adverse drug effects; ...

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental phenomenon commonly presented to the primary care physician for diagnosis and treatment. The primary care physician has the capability to diagnose ADHD and should remain well-informed in the current body of literature regarding ...

Infertility affects one in four female physicians in the United States, yet the topic of fertility among female physicians is understudied and warrants focused strategies to implement change. Factors that exacerbate the rates of infertility in female physicians include intentional delays...

Abuse of older people, also known as elder abuse, occurs when there is harm or distress to older adults from an action or lack of action by an individual expected to be trusted. Abuse of older people comes in different forms including physical abuse, psychological or emotional abuse, sexual abuse, f...

This is a case study regarding a 37-year-old male with no significant medical history who presented with progressive, nonradiating, bilateral abdominal discomfort. The patient noted a tender hot spot in his left lower quadrant. Review of symptoms revealed unintentional weight loss of 20 pounds and g...

As we approach the end of my term as ACOFP president, I’m proud of what we’ve accomplished and how our organization is poised to excel in the future. My presidential theme of Legacy and our focus on: (1) increasing engagement among our members, (2) increasing collaborations with other organizations...

As the newly appointed editor of the Osteopathic Family Physician Journal, I am honored to introduce myself to our readership. I am a dually boarded Family and Emergency Medicine Physician, and I also serve as the Associate Dean of Clinical Affairs at the Edward Via College of Osteopathic Med...

Dear Members, As President of the American College of Osteopathic Family Physicians (ACOFP), I am delighted to extend a warm welcome to the readers of this summer issue of the Osteopathic Family Physician . This issue holds particular significance as we commemorate several remarkable milestones ...

Osteopathic medicine is recognized for training and parity with other medical fields that treat and take care of patients. And osteopathic medical schools continue to graduate accomplished physicians who use all aspects of their training to carefully consider the needs of their patients to treat ...