Inside Family Medicine

IFM | FASDs in Primary Care: Recognition, Prevention, and Support

AAFP Chief Medical Officer and Senior Vice President of Education, Inclusiveness and Physician Well-Being Margot Savoy, MD, MPH, FAAFP, welcomes back Jeffrey Quinlan, MD, FAAFP, a family physician and University of Iowa department leader with a 28-year US Navy career, to discuss his AAFP work on fetal alcohol spectrum disorders (FASDs) and substance use in pregnancy. He emphasizes that alcohol is a teratogen with no safe amount or timing in pregnancy and outlines associated neurodevelopmental, craniofacial, organ, growth and behavioral effects. The conversation covers primary care screening and early identification using exposure history and clinical signs, common diagnostic frameworks (COFASP and the University of Washington 4-digit code), multidisciplinary care coordination and prevention through routine screening (AUDIT-C or NIAAA single-question), preconception counseling and stigma reduction. For longitudinal care, Quinlan highlights early intervention, individualized care plans, family support and training, school accommodations, behavioral therapies, nutrition support and medications for comorbid conditions, all using a strength-based approach. Topics by Timestamp 00:00 Welcome and Guest Intro 00:51 Clinical Background and Exposure 01:55 No Safe Alcohol in Pregnancy 04:02 Screening and Diagnosis Basics 06:46 Building the Care Team 09:05 Preventing Alcohol Exposed Pregnancy 12:38 Long Term Care and Interventions 20:13 Key Takeaways and Closing Additional Resources Clinician Resources * Substance use di [https://www.aafp.org/clinical-insights/cognitive-and-behavioral-health/substance-use-disorders]sorders [https://www.aafp.org/clinical-insights/cognitive-and-behavioral-health/substance-use-disorders]: Clinical guidance and practice resources from the AAFP * Alcohol use during pregnancy and fetal alcohol spectrum disorders [https://www.aafp.org/fpm/2026/0500/alcohol-use-during-pregnancy]: Educational supplement on improving screening, diagnosis and treatment of children and families with FASDs, and improving support services and access to care for impacted women and families * IFM | Medical insights on cannabis and alcohol use during pregnancy [https://aafp.libsyn.com/ifm-medical-insights-on-cannabis-and-alcohol-use-during-pregnancy]: Jeffrey Quinlan, MD, FAAFP, addresses alcohol and cannabis use during pregnancy in primary care * Treating excessive alcohol use [https://www.aafp.org/clinical-insights/cognitive-behavioral-health/substance-use-disorders/excessive-alcohol-use]: Guidance for screening, diagnosing and treating excessive alcohol use in primary care settings * Tobacco and nicotine use | Prevention and cessation resources [https://www.aafp.org/clinical-insights/cognitive-behavioral-health/substance-use-disorders/tobacco-nicotine-prevention-cessation]: Comprehensive toolkit to assist in helping patients stop smoking or prevent them from starting Patient Resources * Substance use disorder [https://familydoctor.org/condition/substance-use-disorder/]: Evidence-based patient educational resource * Opioid addiction [https://familydoctor.org/condition/opioid-addiction/]: Evidence-base patient educational resources Related AAFP CME Activities * Substance Use Disorders Edition 2 [https://www.aafp.org/cme-and-events/topics/chronic-diseases-ambulatory-medicine/substance-use-disorders]: CME meeting DEA-mandated eight hours of Medication Access and Training Expansion (MATE) Act * Addiction Treatment and Care CME for Family Physicians [https://www.aafp.org/cme-and-events/topics/chronic-diseases-ambulatory-medicine/addiction-treatment-and-care]: Free, on-demand CME to gain deeper understanding of the neurobiology and psychosocial dimensions of substance use disorders, and learn practical strategies to integrate harm reduction, trauma-informed approaches and culturally responsive care into your practice Funding Statement: This activity is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1,219,331 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. Disclaimer: Copyright 2026. AAFP. The views presented in this broadcast are the speaker's own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.

CME | Menopause, Minus the Mystery: What Every Clinician Should Know

In this re-released episode of CME on the Go, originally published on 9/2/2025, our hosts delve into menopause, providing family physicians with essential insights, treatment options, and the latest research findings. While discussing hormone replacement therapy, non-hormonal treatments, and the interpretation of the Women's Health Initiative, the hosts emphasize patient-centered care and the natural progression of menopause. This episode aims to equip physicians with practical tools and knowledge, enhancing their ability to support patients through this critical stage of life. Learning Objectives 1. Recognize the spectrum of menopausal symptoms across age groups, including premature menopause, and assess appropriate treatment and contraceptive options. 2. Evaluate the risks and benefits of hormone therapy in postmenopausal women, including red flags that warrant closer monitoring or alternative management. 3. Recommend evidence-based non-hormonal strategies for managing menopausal symptoms and support patient-centered conversations that normalize and destigmatize the menopause experience. After listening to the podcast episode, claim 0.5 AAFP credit by following the provided link. https://www.aafp.org/assessment/take/18338/e [https://www.aafp.org/assessment/take/18338/e] Additional Resources AFP 7/2025: https://www.aafp.org/pubs/afp/issues/2025/0700/editorials-menopausal-hormone-therapy.html [https://www.aafp.org/pubs/afp/issues/2025/0700/editorials-menopausal-hormone-therapy.html] AFP 7/2023: https://www.aafp.org/pubs/afp/issues/2023/0700/menopausal-symptoms.html [https://www.aafp.org/pubs/afp/issues/2023/0700/menopausal-symptoms.html] AFP 5/2025: Testosterone for menopause?: https://www.aafp.org/pubs/afp/issues/2025/0500/fpin-ci-topical-testosterone-menopausal-symptoms.html [https://www.aafp.org/pubs/afp/issues/2025/0500/fpin-ci-topical-testosterone-menopausal-symptoms.html] The Menopause Society with certification: https://menopause.org/ [https://menopause.org/] Disclosure: It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All individuals in a position to control content for this session have indicated they have no relevant financial relationships to disclose. Disclaimer: Copyright 2026. AAFP. The views presented in this broadcast are the speaker's own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.

FFFM | FamMedPAC: How Family Physicians Engage in Policy and Politics

In this episode of Fighting for Family Medicine, David Tully, AAFP vice president of government relations, previews recent AAFP advocacy updates and interviews Domenic Casablanca, MD, FAAFP at FMX about the Family Medicine Political Action Committee (FamMedPAC). Highlights include urging HHS to preserve family medicine representation on the United States Preventive Services Task Force, AAFP advocacy efforts around Medicare payment reform and student loan repayment updates. Casablanca explains how a political action committee pools member donations to support vetted, bipartisan candidates, describes the importance of relationship-building with lawmakers and cites AAFP advocacy wins. He also shares how physicians can stay involved and make their voices heard. Topics by Timestamp 00:00 Welcome and Episode Setup 00:38 Advocacy Highlights Roundup 01:34 Medicare Payment Reform Push 02:40 Workforce Loans and Visas 04:33 Pharmacist Services Concerns 05:22 Meet the FamMedPAC Chair 06:11 What a PAC Does 06:56 Easy Ways to Advocate 08:29 How Candidates Are Chosen 09:50 Why Bipartisan Matters 11:38 Relationship Building Stories 13:44 Election Cycle Strategy 16:28 PAC Wins for Family Medicine 18:25 Hot Policy Issues Now 20:41 Career Advice for New Docs 24:10 Final Call to Engage 25:13 Wrap Up and Resources Additional Resources * Op-ed: Making America healthy again needs more than a committee [https://www.fiercehealthcare.com/providers/op-ed-making-america-healthy-again-requires-more-committee] * [2026-04-14] Kaine & Courtney Lead Bicameral Resolution to Repeal... [https://www.kaine.senate.gov/press-releases/kaine-and-courtney-lead-bicameral-resolution-to-repeal-trump-administration-rule-to-politicize-public-service-loan-forgiveness-program] * ICYMI: Congresswoman Schrier Introduces Bipartisan Legislation to Expand Childhood Vaccine Access | Representative Kim Schrier [https://schrier.house.gov/media/press-releases/icymi-congresswoman-schrier-introduces-bipartisan-legislation-expand-childhood] * Will AI destroy or boost healthcare? Medical professionals weigh in [https://www.washingtonexaminer.com/policy/healthcare/4542829/ai-destroy-boost-healthcare-medical-professionals-weigh-in/] * Physician groups react to visa freeze reversal with praise, questions [https://www.beckershospitalreview.com/quality/hospital-physician-relationships/physician-groups-react-to-visa-freeze-reversal-with-praise-questions/] * Joint Letter Requesting National Interest Exceptions and Expedited Visa Processing for Physicians - April 8, 2026 [https://www.aafp.org/assets/image/upload/v1778216474/LT-DHS-ExpeditedVisaProcessing-040826.pdf] * Furr Testimony [https://d1dth6e84htgma.cloudfront.net/HHRG_119_IF_14_Wstate_Furr_S_20260520_c8b4167288.pdf] * Health Hearing: Examining the Medicare Physician Fee Schedule, MACRA, and Opportunities for Payment Reforms [https://energycommerce.house.gov/events/health-hearing-examining-the-medicare-physician-fee-schedule-macra-and-opportunities-for-payment-reforms] Disclaimer: Copyright 2026, AAFP. The views presented in this broadcast are the speaker's own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. The AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.

IFM | Whole Health: Medicine's Course Correction

In this episode of Inside Family Medicine Andrew Bazemore, MD, MPH, and Beth Polk, MD, FAAFP join us to discuss whole health in primary care. Dr. Bazemore distinguishes whole health (physical, behavioral, spiritual and socioeconomic well-being across individuals, families and communities) from whole health care (how care is organized), emphasizing a shift from "What's the matter with you?" to "What matters to you?" Dr. Polk connects whole health to lifestyle medicine's pillars and stresses addressing drivers of outcomes beyond the exam room, including social needs. They cite examples from the VA whole health model and community health centers, discuss team-based care, group visits and using existing evaluation and management (E/M) billing while advocating for payment reform. The episode highlights training needs in residency programs, small, actionable practice changes, clinician well-being and the risks and opportunities of AI in supporting whole health. Topics by timestamp 00:00 Welcome and guests 01:25 Why family medicine 03:36 Why whole health now 05:22 Defining whole health 08:22 Lifestyle medicine link 10:54 Principles and team care 13:03 Real-world examples 16:09 Billing and payment reality 22:05 Training and resources 25:57 Takeaways and next steps 29:51 Salutogenesis explained 30:57 AI and closing Additional resources Family Physicians: Leaders in Whole Health [https://www.aafp.org/pubs/fpm/issues/2025/0500/beyond-the-beltway.html] AAFP Pilot Program Shows Value of Lifestyle Medicine [https://www.aafp.org/news/health-of-the-public/whole-health-project-impacts.html] Prevention & Wellness [https://www.aafp.org/family-physician/patient-care/prevention-wellness.html] Scaling Whole Health Strategies in Primary Care: Action Brief [https://www.aafp.org/dam/AAFP/documents/patient_care/public_health/whole-health-action-brief.pdf] Disclaimer: Copyright 2026. AAFP. The views presented in this broadcast are the speaker's own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.

CME | From Awkward to Affirming: Mastering the Sexual History

In this episode of CME On the Go, our hosts discuss how family physicians can take a comprehensive, sensitive sexual history. They highlight common discomfort and bias in asking "Are you sexually active?" and emphasize using respectful, gender-inclusive language, humility, trauma-informed care and clear medical purpose to avoid voyeurism, with supportive EHR documentation when possible. They review terminology around sex, gender and sexuality and outline the CDC "Five Ps" framework—partners, practices, protection from STIs, past history of STIs and pregnancy intention—adding two additional Ps: permission and primary sexual and gender identity. They suggest open-ended questions, assess STI risk and prevention, address sexual function and trauma and revisit the sexual history during major life transitions. Learning Objectives 1. Recognize the clinical and relational consequences of poorly conducted sexual histories, including the role of implicit bias and documentation challenges in EMRs and patient portals. 2. Differentiate between sex, gender, and sexual identity to enhance inclusive, respectful communication during sexual history taking. 3. Demonstrate strategies to reduce personal discomfort and foster a safe, affirming environment for patients during sensitive conversations. The AAFP has reviewed From Awkward to Affirming: Mastering the Sexual History and deemed it acceptable for up to 0.50 Enduring Materials, Self-Study AAFP Prescribed credits. Term of Approval is from 05/18/2026 to 6/4/2027. Physicians should claim only the credit commensurate with the extent of their participation in the activity. The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The American Academy of Family Physicians designates this Enduring Materials for a maximum of 0.50 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. CME activities approved for AAFP credit are recognized by the AOA as equivalent to AOA Category 2 credit. After listening to the podcast episode, claim 0.5 AAFP credit by following the provided link. https://www.aafp.org/assessment/take/19939/e [https://www.aafp.org/assessment/take/19939/e] References and Resources Yale Reflections – Gender Glossary A clear, accessible glossary of terms related to sex, gender and sexual orientation. https://reflections.yale.edu/article/sex-gender-power-reckoning/gender-glossary [https://reflections.yale.edu/article/sex-gender-power-reckoning/gender-glossary] CDC – Taking a Sexual History CDC guidance on taking an inclusive, patient-centered sexual history in clinical care. https://www.cdc.gov/sti/hcp/clinical-guidance/taking-a-sexual-history.html [https://www.cdc.gov/sti/hcp/clinical-guidance/taking-a-sexual-history.html] American Family Physician – Sexual Health History: Techniques and Tips Evidence-based strategies for comprehensive, affirming sexual health histories in primary care. https://www.aafp.org/pubs/afp/issues/2020/0301/p286.html#afp20200301p286-b3 [https://www.aafp.org/pubs/afp/issues/2020/0301/p286.html#afp20200301p286-b3] Disclosure: It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All individuals in a position to control content for this session have indicated they have no relevant financial relationships to disclose. Disclaimer: Copyright 2026. AAFP. The views presented in this broadcast are the speaker's own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.