Consider half life during drug detoxification

Meds
August 30, 2011

A young man on my sobriety-based detox program (only after showing positive for opiates) admitted to heroin-usage, but hedged the matter saying it was “5 days ago.” His implicit presumption was that an isolated episode, days ago — compared to continuous, more recent, heroin-usage — would lessen the likelihood of his getting kicked off the program.

Is his story of “no heroin [ingestion] in the last five days,” likely, the whole …

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Consider half life during drug detoxification

Personal responsibility is needed to treat drug addiction

Patient
August 24, 2011

A 44-year-old man came to my office to begin Suboxone in hopes of stopping his injecting heroin. He was raised well by married parents, whose other four children have not indulged in narcotics.

He lives with a friend, unable to contribute to rent while “not working” yet somehow he affords $50 per day for narcotics through (self-admitted) hustling (comprising: working as one tentacle of the drug-dealers’ network, shoplifting, borrowing with no …

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Personal responsibility is needed to treat drug addiction

How an ACO will affect the relationship between a doctor and a patient

Policy
May 16, 2011

At the heart of medicine is the relationship between a doctor and a patient.

The more a doctor knows about his patients, the better. While visual changes and numbness might represent migraine symptoms for one patient, for another they could forebode a stroke. Having followed patients through the stages of life, participating in their medical experiences firsthand rather than solely reviewing those as written case-files — I can vouch that knowing …

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How an ACO will affect the relationship between a doctor and a patient

Should doctors give marriage advice?

Patient
February 2, 2011

Doctors have no trouble or compunction giving these good pieces of advice:

  • stop smoking
  • lose weight
  • eat less saturated fat
  • wash your hands
  • vaccinate
  • schedule your mammogram
  • get a colonoscopy

These all likely can augment both life quality and expectancy.

Do doctors, then, (in appropriate situations obviously) go the extra mile and tell a patient to get married? There are reasonable reports church-going adds to longevity, but with sensitivity to broaching religious beliefs, doctors may be reluctant to suggest …

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Should doctors give marriage advice?

Cholesterol medication cost should not be prohibitive

Patient
December 5, 2010

Recently, I had a patient visiting me for the first time. He basically a “syndrome X” type of guy: middle-aged, overweight, high cholesterol, high blood pressure. He’s not the most personally careful individual, with a history of domestic altercation, some prison time. Almost goes without saying he drinks too much and smokes cigarettes.

Well, he wanted his cholesterol medication restarted since he has just now started receiving “insurance”, MassHealth, Massachusetts’ state …

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Cholesterol medication cost should not be prohibitive

Doctors working in an ambulatory care clinic

Physician
October 18, 2010

It would be difficult today to be connected to medicine as either a provider or a consumer and not be aware of the existence of free-standing ambulatory care centers.

Their usual habitat is along a suburban commercial strip, and their presence is generally announced by a well-lit sign displaying a hyphenated medical name, corporate-logo style. The ambulatory care center, known to much of the public as the “walk-in clinic,” is less …

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Doctors working in an ambulatory care clinic

Why are hearing aids so expensive, and reading glasses so cheap?

Conditions
September 7, 2010

I am currently 53 years old, but I recently found an imperfection in my near-vision.  I was probably laboring for a year or so before caving in: purchasing reading glasses. I am using them right now and they have made all the difference.

In the space of a few months, I went from no reading glasses to seven pairs. I bought all seven online together as a package recently, for the …

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Why are hearing aids so expensive, and reading glasses so cheap?

Pharmaceutical sponsored dinners have educational value

Meds
August 5, 2010

It is insulting to think that doctors who are ostensibly smart enough to save one’s life are in fact so stupid, or merely gullible enough, to be swept away by what is in actuality only a very weak potion of sales-presentation intermixed with and embedded within generally informative and pharmaceutical-balanced subject-focused medical lectures.

Such lectures occur usually at a private function room at a restaurant or, in conjunction with a served …

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Pharmaceutical sponsored dinners have educational value