FAMILY MEDICINE - PREVENTION + OUTPATIENT WORKFLOW

YEAR 3 | PAGE 31E - AGENDA -> ACUITY -> PREVENTION -> CONTINUITY -> FOLLOW-UP

WHY FAMILY MEDICINE IS A PRIORITIZATION CLERKSHIP

A single outpatient visit can contain an acute complaint, uncontrolled chronic disease, prevention gaps, medication problems and social barriers. The student must set an agenda, identify what is urgent, close high-value preventive gaps, avoid unnecessary testing and create a follow-up plan that works across time - not just solve one diagnosis.

A. THE OUTPATIENT FIRST-PASS FRAME

Step	Ask yourself	Output
1. Agenda + acuity	What brought the patient in? What is the patient most concerned about? Is there a red flag that changes the visit sequence?	Shared agenda + urgent problems first.
2. Context + medications	Age, pregnancy possibility, comorbidities, allergies, adherence, OTC/supplement use, recent care, social access and health literacy?	Accurate medication/reconciliation and context.
3. Focused assessment	Which history/exam findings materially change the differential or the need for testing?	Problem representation + ranked outpatient differential.
4. Chronic control	Are hypertension, diabetes, lipids, asthma/COPD, CKD, obesity or behavioral conditions controlled? Any complication or treatment toxicity?	Control status + one or two highest-value actions.
5. Prevention	What screening, vaccination, counseling or reproductive/sexual-health needs are due based on age, risk and prior history?	Current prevention plan tied to official guidance.
6. Follow-up + safety net	What should improve, when should the patient return, which result must be tracked, and what symptom should trigger urgent care?	Closed loop: follow-up interval + contingency + ownership.

B. PREVENTIVE CARE - THINK AGE + RISK + PRIOR HISTORY + PREFERENCE

Lane	High-yield reasoning	Shelf / clinic anchor
Cancer screening	Age + organ/risk history + prior result + life expectancy + patient preference.	Know common colorectal, cervical, breast and lung screening logic, but verify current USPSTF recommendations before using exact intervals.
Cardiometabolic	Blood pressure, tobacco exposure, weight, diabetes risk, lipids/ASCVD risk, exercise and nutrition.	Prevention questions often ask who should be screened/counseled and what finding requires confirmation before treatment.
Vaccination / infection	Age, pregnancy, immune status, chronic disease, exposure/travel and prior immunization.	Use the live CDC schedule and notes; do not rely on an old mnemonic for vaccine timing.
Behavioral health / substance	Depression/anxiety, suicide risk when indicated, alcohol/drug use, sleep, intimate-partner violence and readiness to change.	Primary care prevention includes behavioral health and brief intervention, not just cancer screening.
Reproductive / sexual health	Pregnancy intention, contraception, STI/HIV risk, menopause and preconception care when relevant.	Preventive care is individualized by life stage and risk rather than assumed from age alone.
Older adult function	Falls, cognition when indicated, hearing/vision, polypharmacy, function, goals of care and caregiver burden.	A normal lab panel does not replace function, medication review and safety.

B. PREVENTIVE CARE - THINK AGE + RISK + PRIOR HISTORY + PREFERENCE

CURRENT-GUIDELINE RULE: Screening and vaccine recommendations change. Build the reasoning framework, then use the live official table for exact ages, intervals, contraindications and shared-decision categories. STFM - National Family Medicine Clerkship Curriculum USPSTF - Current A and B Recommendations CDC - Adult Immunization Schedule CDC - Child and Adolescent Immunization Schedule Doctor High Yield - Family Medicine Review for Step 2 CK / Shelf 2026/27 clerkship-expanded edition - verify school and official exam updates before testing