Author's posts
DOC Holiday Party
The Duke Outpatient Clinic celebrated the holiday season with a DOC Holiday party on December 15th at the Duke GIM offices in downtown Durham. There was dancing, karaoke, wonderful food, carols and lots of wonderful smiles. See photos from the event in the gallery below!
New food stamp rules – important!!
There are new food stamps rules that require clients under 50 to prove they need them if they are not working (otherwise, they can only get 3 months in 3 years). I imagine this will impact MOST of our clients who don’t yet have SSI. Below are the reasons someone might qualify for food stamps. Clients …
Bivalent mRNA vaccines
Even unvaccinated individuals can jump straight to receiving a single bivalent vaccine, and then if older or severely immunocompromised, receive 1 or 2 additional doses, respectively. The number of bivalent doses varies by age, vaccine, previous COVID-19 vaccines received, and the presence of moderate or severe immune compromise. For people who are not moderately or …
Maestro Care (Epic) Hyperdrive
What is Hyperdrive? Epic has been migrating all of its code to the web over the past few years. As a result, there are user interface changes that occur in this process. The migration to Hyperdrive gives Epic development options they have never had before. Duke implemented Hyperdrive for over 500 pilot users the 1st …
CKD for Primary Care
Chronic Kidney Disease CKD Definition: One or both for 3 months GFR <60 Albuminuria >30mg/day (or other markers of kidney damage) Staging of CKD (colors indicate prognosis) Which Urine Protein should I be checking? Albumin to Cr Ratio (ACR) Protein to Cr Ratio (PCR) · More specific for glomerular injury and more precise at lower …
Diane Bullock farewell
Diane Bullock has made the decision to leave Duke Outpatient Clinic to spend time with her family. Her last day was December 15, 2022. Diane was a joy to work with and she will be greatly missed. Please join me in thanking Diane for her service to our clinic and patients. Thank you Diane, we wish you the …
A Love Song to All the Helpers
Dear DOC Community: Today is the Winter Solstice, the longest night of the year. As 2022 comes to a close and we welcome the slow return of the sun, I offer you a poem called “A Love Song to All the Helpers.” You may have heard me read this before—it’s one of my favorites, and …
1-minute primary care approach to elevated AST/ALT
Here is an amalgamation of 2017 ACG guidelines and practices by some of Duke’s hepatologists on approaching hepatocellular pattern of liver injury. #Elevated AST/ALT ideally confirm elevation with repeat AST/ALT initial studies: CBC, CMP and INR to evaluate albumin, INR, platelets, bilirubin, and sodium HAV/HBV/HCV studies (easily found as “acute hepatitis panel”) and iron studies look at …
Winter Emergency Shelter in Durham for Winter 2022-2023
Cold weather emergency shelter options in Durham are LIMITED this year and different from the past. The Trinity Church white flag shelter is NOT open. The Carolina Duke Inn is NOT part of the homeless system. There are two pathways for winter emergency shelter — Entry Point prioritization to limited White Flag beds operated by …
PHQ-9 and GAD-7 Flowsheets
We are working on increasing the frequency of our depression and anxiety screening for our patients. As a reminder, you can request that any patient get a PHQ-9 by entering that in the notes section of the visit on your Epic homepage. (see Shannon Herndon’s email from earlier this year for a refresher). Once your …
