Context and Trade-offs in Family Medicine

This issue contains several articles that highlight the effect of context and tradeoffs encountered in the practice of family medicine. Some articles demonstrate how context affects the implementation of the patient-centered medical home model, the community risk of a measles outbreak, the rate of complementary and alternative medicine among different generations, and the number of family physicians primarily providing urgent and emergent care in a region. Tradeoffs are explored in articles that look at how electronic medical record use has changed the composition of workload in primary care and how the burgeoning number of clinical guidelines affects the choices made by family physicians. A look at diabetic patients' perceptions of their risk of negative outcomes reveals an interesting pattern of underestimation of the risk of death. Patients with chronic mental disorders are at risk of having significant difficulties in the workplace, which may place a heavy cost on the individual and society. An interesting retrospective study found that it takes a surprising amount of replacement therapy to correct vitamin D deficiency.