A response to “The overwhelming reality of primary care: Why doctors still persevere.”
I am a primary care patient in a rural area of a western state, and I have not seen the same physician or other provider more than two or three times in the past 20 years.
I am a primary care patient, and I have 10 minutes to explain my entire medical history, including my neurologic, musculoskeletal, and …
The hidden health crisis
Low testosterone (low T) is one of the most underdiagnosed and misunderstood health conditions facing men today. Studies show that nearly 40 percent of men over age 45 and 50 percent of men over 80 have low testosterone levels. However, what’s more troubling is that only 20 percent of these men are ever diagnosed or treated.
The symptoms are often subtle but profound, affecting physical health, mental well-being, …
Living with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or long COVID can transform every aspect of life, including one that often feels too delicate or taboo to address: sex and intimacy. These conditions introduce physical limitations, emotional strain, and communication challenges that can make intimacy feel out of reach. But here’s the truth: intimacy is possible—it just looks different, and that’s OK!
Understanding the impact of ME/CFS and long COVID on intimacy
Both …
Dear medicine,
We need to take a break. I’ve finally realized that this relationship isn’t healthy for me—in fact, it’s borderline abusive. For a long time, I didn’t realize I was in an abusive relationship. We’re taught that it’s OK when patients curse at us, threaten us, and even sometimes physically assault us. Unfortunately, for many of us, medicine checks many of the boxes of abusive relationships.
Not realizing we’re in an …
Longevity can be a polarizing topic. For some of us, it conjures images of a grandparent’s final years, filled with chronic diseases and prolonged suffering. Understandably, we would not want any part of that.
However, longevity science is not only about extending lifespan but also healthspan — the period of life spent in good health, free from debilitating conditions. While medicine has not yet eradicated such age-related diseases, research shows that …
The management of pain in clinical practice often involves navigating the critical tension between compassionate care and ensuring patient safety. While subjective self-reports of pain are essential for understanding a patient’s experience, relying solely on these assessments may risk overtreatment, leading to adverse outcomes. Incorporating objective measures can enhance safety and maintain clinical integrity without compromising compassion.
The role of objective measures in pain management
1. Promoting patient safety
As medical students, we all take the Hippocratic oath—a pledge to help patients and, of course, not to cause harm in any treatments we provide. It is a core element in the care of our patients. We would never want to do anything that could make things worse. But is it that simple?
As medical diseases have become more and more complex, can we ethically say we will not offer a …
Efforts to generate a resource of postmortem brain tissue for research are in their infancy. Autism BrainNet, a program of the Simons Foundation, is trying to jump-start those efforts. Currently, there are fewer than 200 postmortem autistic brains in the Autism BrainNet program available to researchers worldwide who are looking into the underlying biological causes of autism and related neurodevelopmental disorders. Postmortem brain tissue accelerates research efforts and advances …
Rachel was making her 25th visit to the emergency department. The wound on her leg from injecting drugs had spread to her entire calf and required a lengthy course of antibiotic treatment in the hospital. The few times she had been admitted to the hospital, she had left without finishing treatment because the pain and withdrawal symptoms were too much to bear. On her most recent visit, she finally stayed to …
Dementia is advancing at an unprecedented rate—every three seconds, another person is diagnosed. Currently, 55 million people worldwide live with dementia, and by 2050, that number could soar to 139 million. These figures aren’t mere statistics; they represent individuals, families, and communities facing complex, life-altering challenges. For primary care providers, who often stand as the first line of defense, this signals a crucial need for precise, sensitive tools to …
Small intestinal bacterial overgrowth (SIBO) is a little known gastrointestinal (GI) disorder with links to irritable bowel syndrome (IBS). Today, it takes an average of about six years for patients to receive a proper IBS diagnosis and begin a course of treatment, all the while experiencing debilitating symptoms from this disease.
Despite SIBO’s long documented medical history, it is poorly understood in comparison to similar chronic GI conditions. While there have …
I don’t know when the word burnout came into my vocabulary, but I feel that we use it constantly in our health care world today. I always thought I was immune to this concept of burnout. My self-talk was that I was strong and nothing would ever happen to me. As a psychiatrist and a yoga practitioner, I thought I was better equipped to “handle my feelings” and be in …
Group therapy can be a powerful treatment modality when done right. Research affirms it as equally effective compared to individual therapy, and the relatively lower cost puts this service within reach of patients who struggle to access behavioral health care due to financial constraints.
Meeting the growing need for mental health support in the United States, recent research published by American Psychologist states that group therapy could save more than $5.6 …
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The growing concern
In the age of marijuana legalization, a troubling health concern is emerging—its impact on fertility. While cannabis enjoys increased social acceptance, its unintended consequences on reproductive health are often overlooked. Daily marijuana use now surpasses high-frequency alcohol consumption, marking a cultural shift that demands urgent attention. Yet, despite accumulating evidence, why does it feel like no one is listening?
As fertility specialists, we are witnessing an alarming trend: couples …
Imagine seeing a commercial featuring Ryder and Marshall from the popular kids’ cartoon Paw Patrol lighting up cigarettes and enjoying a smoke together. It’s hard to fathom that happening, but in 1961 beloved cartoon characters Fred Flintstone and Barney Rubble happily smoked cigarettes in an ad for Winston. Most children of that era could easily recite the ad slogan: “Winston tastes good like a cigarette should.”
With that sort of youth …
A series of behaviors in autistic children, not well addressed by medical providers today, include self-harming, hitting, biting, mouthing, licking objects, pickiness with food, clothing textures, and touching private areas – otherwise known as “sensory behaviors.” Some of these behaviors, often found to be embarrassing, can remain prevalent and persist into adulthood. Part of the problem is that medical providers typically are not educated regarding the nuances of these unique …
Jane Doe – her real name being hidden to protect her young child – thought she knew how to help her eight-year-old son “”Baby Doe.” She was well-educated, employed in a professional role by a federal agency, and comfortable navigating bureaucracies and unresponsive gatekeepers. More importantly, she was a fierce advocate for her child, who had been diagnosed with an autism spectrum disorder and needed occupational and speech therapies, which …
Here are 23 simple things you can do (in five minutes or less) to improve your brain health. Do one of them each day. Keep it up for a few short weeks and your brain will sing your praises.
Attitude of gratitude
The act of being grateful improves mental health in a number of ways, such as making the grateful person less prone to depression and fostering stronger relationships. Becoming more grateful …
As a pediatric dentist and owner of a tongue tie center, I pride myself on having a conservative and collaborative approach when it comes to treating oral restrictions. Too many providers rush to release, and too many parents are misinformed thinking the release is going to be a “magic fix.”
I’ve compiled a list of important things that I feel everyone (both providers and parents) should know about tongue-ties and lip-ties.
1. …
An interview with Jerome Hoffman, MD, professor emeritus at UCLA.
Martha Rosenberg: As professor emeritus at UCLA (University of California, Los Angeles), you engaged in what is laughingly called in academics the “triple threat” of research, teaching, and clinical work for 30 years. Can you please summarize a little of what you did?
Jerome Hoffman: You’re right – I spent my career as an old-style academic, doing those three types of work. …
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