Clinical decision support that reasons like a family physician: order the screening that is actually due by USPSTF, start the right first-line antihypertensive, weigh the statin by ASCVD risk, and manage depression by the PHQ-9 — with the decision rule and exactly what would change it. Built for verified physicians.
Two real family-medicine questions, each reasoned the way HeyHippocrates answers: the skills fire, the answer is cited, the decision rule is explicit, and what's missing is flagged. Scroll to each.
A 52-year-old here for a wellness visit with no colon screening yet — what is due?
Bring the USPSTF panel to age 52. Colorectal cancer screening is due — a colonoscopy, or FIT or stool-DNA on an interval — recommended from 45 to 75. Screen blood pressure, offer a lipid panel and estimate the ten-year ASCVD risk for the statin conversation, and screen for tobacco and unhealthy alcohol use and for depression. Confirm cervical and breast screening by age, update immunizations, and flag lung screening if the smoking history qualifies.
Decision ruleAge 52 USPSTF: colorectal screening (45–75); BP + lipids + 10-yr ASCVD for statin; tobacco/alcohol + depression screens; cervical/breast by age; immunizations; lung screen if eligible.
Not established from this alone — the personal and family history, prior results and risk factors change what is actually due.
Office readings around 150/95 confirmed by home monitoring, no target-organ disease — the plan?
This is stage 2 hypertension by the 2017 ACC/AHA thresholds, so combine lifestyle change with medication from the start. First-line agents are a thiazide-type diuretic, an ACE inhibitor or ARB, or a calcium channel blocker — not a beta-blocker as monotherapy without a compelling indication. Favor an ACE inhibitor or ARB with diabetes or chronic kidney disease, aim for a target below 130/80, and confirm control with out-of-office readings.
Decision ruleConfirmed BP 140/90+ (stage 2) → lifestyle + first-line agent (thiazide / ACE or ARB / CCB, not beta-blocker alone); ACE or ARB if diabetes or CKD; target below 130/80; verify with home or ambulatory readings.
Not established from this alone — the comorbidity, the out-of-office readings and target-organ damage change the agent and the goal.
Illustrative simulations. The physician always decides.
The exact questions your field searches for — answered in the format the knowledge base speaks: the answer, the decision rule, what's missing, and the source.
Anchor prevention to the USPSTF grade A and B recommendations by age and risk. Screen blood pressure at every eligible visit; screen for colorectal cancer from 45 to 75; screen cervical and breast cancer on their schedules; offer a one-time abdominal aortic aneurysm ultrasound in men 65 to 75 who ever smoked; screen for lung cancer with low-dose CT in the eligible smoker; and screen for depression, tobacco and unhealthy alcohol use. Statin and immunization decisions follow the individual risk.USPSTF
Decision ruleUSPSTF A/B by age + risk: BP; colorectal 45–75; cervical/breast on schedule; AAA once (men 65–75 ever-smokers); lung LDCT if eligible; depression/tobacco/alcohol; statin + immunizations by risk.
Missing data: the age, sex, smoking history and prior results change what is recommended.
Confirm the diagnosis with out-of-office readings, then use the 2017 ACC/AHA thresholds: begin medication at 130/80 or more when the ten-year ASCVD risk is 10 percent or higher or there is diabetes, chronic kidney disease or clinical cardiovascular disease, and at 140/90 or more for everyone. First-line agents are a thiazide-type diuretic, an ACE inhibitor or ARB, or a calcium channel blocker, with the target below 130/80 for most.ACC/AHA 2017
Decision ruleConfirm out-of-office; treat at 130/80+ if 10-yr ASCVD 10%+ or diabetes/CKD/CVD, and at 140/90+ for all; first-line thiazide / ACE or ARB / CCB; target below 130/80.
Missing data: the confirmed readings, the ASCVD risk and comorbidity change the threshold and the drug.
Estimate the ten-year ASCVD risk with the pooled-cohort equations. Offer a moderate-intensity statin when the risk is 7.5 percent or more, and consider one from 5 to 7.5 percent; treat an LDL of 190 or more, or diabetes at age 40 to 75, on their own. Routine low-dose aspirin for primary prevention is no longer recommended for most adults because the bleeding risk offsets the benefit; reserve it for selected higher-risk patients after a shared decision.USPSTF · ACC/AHA
Decision rulePooled-cohort 10-yr ASCVD: statin if 7.5%+ (consider 5–7.5%); LDL 190+ or diabetes 40–75 → statin regardless; aspirin NOT routine for primary prevention — individualize.
Missing data: the risk estimate, the LDL and the bleeding risk change the decision.
Screen adults for depression with the PHQ-2, then the PHQ-9 to grade severity and track response. For mild disease, offer psychotherapy or watchful waiting; for moderate to severe, start an SSRI as first-line with structured follow-up, reassessing in two to four weeks and titrating. Always screen for bipolar disorder and suicide risk before starting an antidepressant, and arrange measurement-based follow-up.USPSTF · PHQ-9
Decision rulePHQ-2 → PHQ-9 for severity; mild → therapy or watchful waiting; moderate–severe → SSRI first-line + follow-up in 2–4 weeks; screen bipolar + suicide risk first; measurement-based care.
Missing data: the severity score, the bipolar and suicide screen and the history change the plan.
Your whole practice, one specialist brain — grounded in champion-authored, cited knowledge.
A generalist family-medicine colleague across prevention and screening, cardiometabolic disease, primary-care mental health, acute care and the older adult — cited, non-directive, always with the decision rule.
Deep specialist agents for preventive care, cardiometabolic disease, primary-care mental health and care of the older adult — each its own soul and knowledge base — plus your own uploaded materials.
From the screening that is due to the first antihypertensive the margin is thin. Only one of these reasons like a family-medicine colleague whose every claim you can trace.
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It reasons in the frameworks you use — the USPSTF grades, the ACC/AHA hypertension thresholds, the pooled-cohort ASCVD equations and the PHQ-9 — and always shows the reasoning, the decision rule and what would change it. The decision always stays your call.
Both. Residents use it to pressure-test a plan and learn the decision rule; attendings use it as a fast, cited second opinion between patients in a busy clinic. Access is gated to verified physicians.
Preventive care, cardiometabolic disease, primary-care mental health and care of the older adult each have their own deep specialist agent on the Pro plan, on top of the full family-medicine scope on Basic.
No. It is physician-facing clinical decision support — a cited thinking partner. It does not diagnose, does not treat, and gives no patient-facing advice. The decision always stays with you.
Every answer is grounded only in champion-authored, cited family-medicine knowledge — traceable, not hallucinated — and always states the decision rule plus what data is missing, instead of a confident guess.
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