Frankly Speaking About Family Medicine

Latest Episodes:

Digesting the Inverted Food Pyramid and Best Evidence on Healthy Eating in 2026 - Frankly Speaking Nutrition Update Jan 21, 2026

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-nutrition-update

Overview: In this episode, we explore the latest changes to the USDA’s nutrition guidelines, trace the history of the food pyramid, and examine the evidence behind current guidance. Come away with tips to counsel patients on nutrition that supports long-term health and reduces chronic disease risk.

Episode resource links:

Review the history of nutrition recommendations from the United States Department of Agriculture (USDA)
Analyze the USDA’s 2026 food guidelines

Guest: Alan M. Ehrlich, MD, FAAFP
Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Are You Still Recommending Aspirin for Primary Prevention? - Frankly Speaking Ep 468 Jan 19, 2026

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-468

Overview: We first discussed aspirin use for primary prevention of cardiovascular disease in 2022 when the USPSTF recommended against it. In this follow-up episode, we review new trial data reinforcing that guidance and help you translate the evidence into safer prevention strategies. Build confidence in supporting patients with evidence-based approaches to reduce cardiovascular risk.

Episode resource links:

Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 2025 Aug 12:ehaf514. doi: 10.1093/eurheartj/ehaf514. Epub ahead of print. PMID: 40796244.

Guest: Robert A. Baldor MD, FAAFP
Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Meningitis Makes a Comeback (Along with Other Infections) - Frankly Speaking Vaccine Update Jan 14, 2026

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-vaccine-update

Overview: In this episode, we discuss the recently updated US childhood vaccine schedule, including key changes and the rationale behind these recommendations. We also talk about the risks of vaccine-preventable illnesses and review vaccine efficacy and safety considerations—helping you navigate evolving guidance and protect patients in primary care.

Episode resource links:

RSV: Pediatrics. 2024. Curns AT, Rha B, Lively JY, et al.
J Infect Dis. 2022 Aug 15;226(Suppl 2):S154-S163. doi: 10.1093/infdis/jiac120
Hep B: N Engl J Med 2019;380:2041-2050 DOI: 10.1056/NEJMra181047
Clin Infect Dis. 2021 Nov 2;73(9):e3317-e3323. doi: 10.1093/cid/ciaa898.
Meningococcal Vaccines and disease: MMWR. Morbidity and Mortality Weekly Report. 2024. Collins JP, Crowe SJ, Ortega-Sanchez IR, et al.
Vaccine. 2019. Wang B, Santoreneos R, Giles L, Haji Ali Afzali H, Marshall H.

Guest: Jillian Joseph, MPAS, PA-C
Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

The views expressed in this podcast are those of Dr. Domino and his guests and do not necessarily reflect the views of Pri-Med.

Babies Can Acquire STIs: The Rationale for Hepatitis B Vaccination at Birth - Frankly Speaking Ep 467 Jan 12, 2026

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-467

Overview: Join us as we discuss recent changes to newborn hepatitis B vaccination recommendations and review the risks, benefits, and rationale for immunizing this patient population. Come away with confidence to navigate new guidance, thoughtfully address parental concerns, and provide evidence-based care that promotes both infant and public health.

Episode resource links:

N Engl J Med 2019;380:2041-2050 DOI: 10.1056/NEJMra181047
Clin Infect Dis. 2021 Nov 2;73(9):e3317-e3323. doi: 10.1093/cid/ciaa898.

Guest: Robert A. Baldor MD, FAAFP
Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

Potatoes and T2DM Risk: Which Preparations Made the Cut? - Frankly Speaking Ep 466 Jan 05, 2026

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-466

Overview: Concerns over eating carbohydrate-rich potatoes have been raised over the last decade with numerous studies suggesting worrisome effects on health. Tune in as we unpack findings from a large study that examined the relationship between potato intake and the risk of developing type 2 diabetes mellitus (T2DM), helping you apply evolving nutrition science to patient counseling.

Episode resource links:

BMJ 2025;390:e082121 http://dx.doi.org/10.1136/bmj-2024‑082121

Guest: Robert A. Baldor MD, FAAFP
Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

Aspirin Plus Anticoagulation: What Are the Risks? - Frankly Speaking Ep 465 Dec 29, 2025

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-465

Overview: Many patients with coronary artery disease take aspirin, but how should clinicians navigate management when an anticoagulant is also needed? In this episode, we review indications for therapy, explore evidence on dual use, and discuss how to counsel patients on balancing cardiovascular benefits with the risks of combination therapy.

Episode resource links:

Lemesle G, Didier R, Steg PG, et al. Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation. N Engl J Med. Published online August 31, 2025.

https://www.nejm.org/doi/full/10.1056/NEJMoa2507532

Guest: Alan M. Ehrlich, MD, FAAFP
Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

A Spark of Motivation: Leveraging Lung Cancer Screening to Drive Change - Frankly Speaking Ep 464 Dec 22, 2025

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-464

Overview: Beyond detecting disease early, lung cancer screening provides an opportunity to encourage smoking cessation. In this episode, we review USPSTF guidelines, compare screening effectiveness, and explore how the use of a pulmonary function test (PFT) and a lung age estimator can help people who smoke better understand their risks and inspire behavior change.

Episode resource links:

USPSTF: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening
BMJ (Clinical Research Ed.). 2008;336(7644):598-600. doi:10.1136/bmj.39503.582396.25.
BMC Public Health. 2022;22(1):1164. doi:10.1186/s12889-022-13583-1.

Guest: Robert A. Baldor MD, FAAFP

Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

Rethinking Chronic Back Pain: Practical Behavioral Interventions for Primary Care - Frankly Speaking Ep 463 Dec 15, 2025

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-463

Overview: Listen in as we discuss how integrating behavioral therapies into the management of chronic back pain can improve function, reduce opioid use, and empower patients. Boost your clinical toolkit with evidence-based strategies that enhance outcomes while aligning with evolving guidelines for safer, multimodal approaches to chronic pain care.

Episode resource links:

Zgierska AE, Edwards RR, Barrett B, et al. Mindfulness vs Cognitive Behavioral Therapy for Chronic Low Back Pain Treated With Opioids: A Randomized Clinical Trial. JAMA Netw Open. 2025;8(4):e253204. doi:10.1001/jamanetworkopen.2025.3204
Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain - United States, 2022. MMWR Recomm Rep. 2022 Nov 4;71(3):1-95. doi: 10.15585/mmwr.rr7103a1. PMID: 36327391; PMCID: PMC9639433.

Guest: Jillian Joseph, MPAS, PA-C

Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

Migraine Relief Starts Here: Current Management Tools for PCPs - Frankly Speaking Ep 462 Dec 08, 2025

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-462

Overview: In this episode, we examine migraine—a leading cause of disability worldwide that is often underdiagnosed and undertreated in primary care. You’ll learn how to distinguish migraine from other headache disorders, identify who is most affected, and explore both acute pharmacologic options and preventive strategies that can reduce attack frequency and improve patients’ quality of life.

Episode resource links:

El Hussein, M. T., & Fraser, L. (2025). Pharmacologic Management of Migraine in Primary Care: Nurse Practitioner Guide. The Journal for Nurse Practitioners, 21(9), 105501.
Qaseem, A., Tice, J. A., Etxeandia-Ikobaltzeta, I., Wilt, T. J., Harrod, C. S., Cooney, T. G., ... & Yost, J. (2025). Pharmacologic treatments of acute episodic migraine headache in outpatient settings: a clinical guideline from the American College of Physicians. Annals of internal medicine, 178(4), 571-578.
Charles, A. C., Tepper, S. J., & Ailani, J. (2025). State of the art in the management of migraine—A response to the American College of Physicians migraine preventive treatment guideline. Headache: The Journal of Head and Face Pain.
Vélez-Jiménez MK, et al. Comprehensive Preventive Treatments for Episodic Migraine: Systematic Review. Front Neurol. 2025
Lanteri-Minet, M., Casarotto, C., Bretin, O., Collin, C., Gugenheim, M., Raclot, V., ... & Lefebvre, H. (2025). Prevalence, characteristics and management of migraine patients with triptan failure in primary care: the EMR France-Mig study. The Journal of Headache and Pain, 26(1), 153.

Guest: Mariyan L. Montaque, DNP, FNP-BC
Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

A Clearer Path for Complicated UTIs: Updated Guidance, Streamlined Care - Frankly Speaking Ep 461 Dec 01, 2025

Show notes

Credits: 0.25 AMA PRA Category 1 Credit™
CME/CE Information and Claim Credit: https://www.pri-med.com/online-education/podcast/frankly-speaking-cme-461

Overview: Complicated urinary tract infections (UTIs) are common in primary care but can be difficult to approach. In this episode, you’ll learn how to identify complicated UTIs, methodically address them, and incorporate new guidance on outpatient management and antibiotic selection to improve diagnosis and treatment for your patients.

Episode resource links:

Complicated Urinary Tract Infections (cUTI): Clinical Guidelines for Treatment and Management https://www.idsociety.org/practice-guideline/complicated-urinary-tract-infections
Koehl J, Spolsdoff D, Negaard B, et al. Cephalosporins for Outpatient Pyelonephritis in the Emergency Department: COPY-ED Study. Ann Emerg Med. 2025;85(3):240-248. https://pubmed.ncbi.nlm.nih.gov/39570254/

Guest: Alan M. Ehrlich, MD, FAAFP
Music Credit: Matthew Bugos

Thoughts? Suggestions? Email us at FranklySpeaking@pri-med.com

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