Issue: Summer 2019 Vol. 14 - Issue 2
      
 
From the Editor's Desk 
Will More Transparency Help Us Lower the Cost of Health Care?
– Lawrence I. Bonchek, MD, FACS, FACC
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Top Tips from Family Practice 
Choosing Wisely XXVIII: Recommendations on Benign Breast Disease, Gastrointestinal and Endoscopic Surgery, and Occupational Therapy
– Alan S. Peterson, M.D.
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Scientific Reports 
Transcarotid Artery Revascularization (TCAR): An Endovascular Alternative to Carotid Endarterectomy for High-Risk Patients
– Meghan Dermody, MD, MS, RPVI, FACS, and Todd Wood, MD, FACC, FSCAI, FSVM, RPVI
This new hybrid approach to carotid stenosis has a potentially lower risk of stroke than conventional endarterectomy or stenting. A temporary shunt between the carotid artery and femoral vein reverses flow in the carotid while angioplasty and stenting are performed. LGH experience is detailed.
 
 
   
Urgent Care Part 2: Meeting a Growing Demand
– Vito J. DiCamillo, M.D., and Stacey Lee Harris
This second article on the dramatic growth of urgent care in Lancaster County focuses on the clinical model used by Penn Medicine LG Health to deliver urgent care. It describes in detail the management of staffing and clinical issues.
 
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Helping Patients with a Serious Illness Understand Their Condition: Lessons from Oncology
– Shanthi Sivendran, MD, MSCR
Patients with cancer often have a poor understanding of their disease and unrealistic expectations of the goals of treatment. This illuminating article discusses the barriers to effective communication with patients, and describes programs at LGH that can improve communication and understanding.
 
 
   
 
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Assessment of Breastfeeding Self-Efficacy in a Family Medicine Residency Practice
– Peggy Nepps, PsyD, and Michael Horst, PhD
Because breastfeeding has proven benefits, the proportion of breastfed infants should be maximized. This study found that a mother’s estimate of her own ability to breastfeed (“self-efficacy”) is an important predictor of success.
 
 
   
 
Non-Operative Management of Epicondylitis 
– Patrick Moreno, MD, CAQSM, RMSK, Jennifer Payne, MD, CAQSM, and Ryan Wennell, DO, CAQSM
Tennis elbow, or lateral epicondylitis, is one of the more common musculoskeletal complaints. This informative article describes its pathophysiology, and several of the latest non-operative therapies.

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