Case study: You are working in a family practice when Joe, a recently divorced

Case study:

You are working in a family practice when Joe, a recently divorced 56-year-old Caucasian man, presents to you with complaints of insomnia and fatigue. He denies any recent injury or specific pain and was last seen in your office 11 months ago where he disclosed that he was going through a divorce due to his sexual orientation. Joe has taken an antihypertensive medication to control his blood pressure for three years and does not report any adverse side effects. Joe has worked in law enforcement for 14 years. He recently discharged his firearm for the first time. Even though no one was injured, Joe has been attending mandated appointments with the department psychologist. Joe reports that he does not have a regular exercise regimen. To relax, he typically goes fishing or has a few beers after his shift. Other than the mandated appointments with the department psychologist, Joe has not sought any mental health treatment. During the appointment, Joe states that it’s hard for him to talk about how he is feeling and begins to cry.

• Four differential diagnoses and rationales with references. Support your answers with peer-reviewed references.
• Create a plan of care for that patient.
• Plan must include pharmacology, non-pharmacology, labs/diagnostics, referrals/interprofessional communications, patient education (10 to 15 individual items minimum), and follow-up.
• Make sure to pick one health maintenance item for this patient (primary or secondary) and explain to the patient why this is important.
• Address one existing or potential social determinant of health for this patient during your visit. How will you help the patient overcome this obstacle to health care?

Peer reviewed citations no lesser than 15 years.