Primary Care

The art of the physical exam: the importance of returning to the basics

Physician

January 26, 2023

“Make thorough inspection.”
– Sir William Osler, MD.

The art of the physical exam is precisely that: an art that must be practiced often, for years on end, and the one that a physician may become a great achiever or skilled but never the master.

When I trained in internal medicine over a decade ago, our program director often harped on this art. I was too naive to understand his message at the …

How receiving medical practice coaching can multiply your income

Curtis G. Graham, MD

Physician

January 26, 2023

Not only does medical practice coaching teach you how to open your mind to who you really are, but it also allows you to bypass the dreaded $20,000 to $50,000 MBA business education that your medical school refused to teach you about.

When you recognize that many highly educated professional athletes hire personal coaches throughout their careers, you must wonder what value they find in being coached. You would think that …

Primary care colonialism: the impact of profit-driven health care on communities

Michael Fine, MD

Policy

January 25, 2023

An excerpt from On Medicine as Colonialism.

For about seventeen years, from 1991 until 2008, I lived in little Scituate, Rhode Island, where I practiced family medicine, and for about eleven of those seventeen years, I practiced out of the basement of my house. It was an older style of primary …

Feeling valued by my boss: How a simple tumbler made my day

Poonam Merai, MD

Physician

January 25, 2023

I arrived at my desk after a holiday hiatus with renewed energy to tackle the day. It sat there, unassuming, on my desk with a note. My heart was giddy, knowing my tea pastime would level up. Opening the letter, I realized it was from my boss. My boss had given me a tumbler, and I felt like a kid on Christmas morning. The excitement seemed out of proportion to …

Why sharing your complete medical history with your clinicians is important

Miles J. Varn, MD

Physician

January 24, 2023

It’s your first visit to a cardiologist because you’ve had occasional episodes of an irregular heartbeat. As you fill out your pre-appointment paperwork, you carefully list the symptoms you’re experiencing and the treatments your primary care physician has recommended before referring you to a specialist. You don’t mention that you recently started taking Lexapro (escitalopram) to treat depression because you’re focused on your heart issue.

But that accidentally omitted information could …

The empathy gap: How a lack of understanding is fueling poor outcomes and health disparities

Nicole Rochester, MD

Physician

January 23, 2023

I recently watched The Color of Care, a documentary highlighting the disparate and inequitable care received by Black and brown individuals during the COVID-19 pandemic. During the movie, Executive Producer Oprah Winfrey opined that one of the primary health care issues is the “empathy gap.” Upon hearing the phrase, I shot up in my chair, as it felt eerily (and painfully) similar to what I described in …

Why primary care physicians should be the quarterbacks in patient care

Brandi Fontenot, MD

Physician

January 22, 2023

“There are, in truth, no specialties in medicine, since to know fully many of the most important diseases, one must be familiar with their manifestation in many organs.”
– Sir William Osler, MD.

I agree with this statement to an extent. However, I wholeheartedly respect and admire many subspecialists whom we all rely on. Disease does not usually wave a red flag and manifest extravagantly in one organ system. It usually is …

Health care leadership: Making medicine a team sport

Robert Pearl, MD

Physician

January 22, 2023

Americans give lip service to the importance of teamwork. But most often, we credit success to individuals. Perhaps nowhere is this “MVP mindset” more apparent than in medicine.

The brilliant lone physician — gallantly battling to save a patient’s life — is the TV-inspired image most of us conjure up when we think of the medical profession. While that archetypal hero was, in fact, the best hope for patients in the …

The impact of religious-spiritual values on individual lives

Scott Abramson, MD

Physician

January 20, 2023

A friend of mine recently went into the hospital for a surgical operation. Afterward, she told me about a conversation she had with her doctors. Meeting with her surgeon and her anesthesiologist before surgery, this retired lifelong Sunday school teacher couldn’t resist the temptation to give them both a Bible lesson. “Let me ask you, doctors,” she inquired, “who do you think performed the first surgery?” As the doctors pondered …

Questioning medical traditions for the sake of patient care

Brian Elliott, MD

Physician

January 20, 2023

The United States consumes forty-six million turkeys every Thanksgiving. Have you ever wondered why? When traditions take hold in society, we start to forget why they existed in the first place. For example, the tradition of eating turkey on Thanksgiving started with a writer named Sarah Josepha Hale, who published scenic depictions of American life in New England. She subsequently campaigned for everyone to adopt her depiction of a cooked …

Direct primary care: more access, more savings, more care

Landen Green, DO

Physician

January 19, 2023

Your doctor will see you now. Really, now. Come on in! Forget about waiting for two months for an appointment, hours on hold, or a six-hour wait at an urgent care clinic. Your doctor can see you now; shoot them a text.

More and more primary care clinics are providing a more personal, accessible, convenient, and affordable health care option called direct primary care (DPC). This model focuses on patients rather …

Doctors struggle with unrealistic expectations and lack of self-care, leading to a lack of mercy towards colleagues

Brandi Fontenot, MD

Physician

January 19, 2023

“Mercy and consideration for the other man, but none for yourself, upon whom you have to keep an incessant watch.”
– Sir William Osler, MD.

Ironic, isn’t it? The physician is expected to go above and beyond, superhuman even, held to an unrealistic standard above most others, and yet, is their own worst critic. (Or was until social media, but that is another writing for another day.)

We continuously hold ourselves to that …

The decline of whole-person treatment in modern medicine

Arthur Lazarus, MD, MBA

Physician

January 19, 2023

Recently, a nurse practitioner responded to one of my op-eds in which I discussed the doctor-patient relationship. The nurse said:

I feel so frustrated at times, by the time constraints forced on us by using a business model of practice. In the 30-plus years I’ve been a nurse, we have moved from patient-centered care (which is the current inaccurate buzzword for the type of care we provide) to …

Read more…

The decline of whole-person treatment in modern medicine

Lean on me: the power of human connection and the support of a caring doctor

Michele Luckenbaugh

Conditions

January 16, 2023

Sometimes in our lives, we all have pain, and we all have sorrow.

But if we are wise, we know that there’s always a tomorrow.

Lean on me when you’re not strong, and I’ll be your friend; I’ll help you carry on,

for it won’t be long ’till I’m going to need somebody to lean on.

Some might recall these lyrics from the song Lean on Me, written in 1972 by American singer-songwriter Bill …

Emotional seasons: 3 vignettes of love, loss, and connection

Susan J. Baumgaertel, MD

Physician

January 14, 2023

At the end of a year and the beginning of another, emotions tend to run high.

Whether it be the loss of a loved one or the tangled web of interactions with relatives, an unexpected illness or travel plan glitches, wonderful moments to cherish, or joyful connections – all are wrapped up like presents topped with emotional bows.

The opening and unraveling part often takes courage and creativity.

This is a series of …

Don’t lose yourself: a warning from a divorced physician

M. Michelle McClelland, MD

Physician

January 13, 2023

I was going through drawers, finishing unpacking as best I could, when I stumbled upon one of those moments that feels like a puzzle piece sliding into place. I recently divorced, moved across the country, took a leave of absence from work, and changed my job. It’s been tumultuous, but grounding. I’m back in my home state, near good friends and family, and in therapy. I’m sleeping 8 hours a …

Physician speaks out about being threatened by a patient and betrayed by an organization

Anonymous

Physician

January 13, 2023

I’ve been practicing internal medicine for over a decade now. I was drawn to this field because of my admiration for Dr. William Osler and the superb physicians I have met who embody his qualities. As an internal medicine physician, I am expected to be a critical thinker and a “doctor’s doctor,” specializing in complexity and solving problems with multiple layers, like peeling an onion. However, I never imagined that …

Is success really just about wealth and achievements?

Ketan Kulkarni, MD

Physician

January 11, 2023

Success is a word that is used frequently across the globe. Almost everyone wishes to experience a great amount of success all the time. We are constantly bombarded with images of success through the internet, mainstream media, and social media. These images often depict high net worth, lavish possessions, luxurious lifestyles, impressive titles or achievements, exotic travel, and more. However, data shows that this appearance of perceived success is not …

The intertwined roles of parenting and medicine: How personal experience can enhance patient care

Roxanne Almas, MD, MSPH

Physician

January 10, 2023

As a pediatric subspecialist in the division of developmental medicine at our hospital and a mother of two school-aged children, I constantly strive to find new approaches to both parenting and my medical practice. Some of these strategies work well, while others do not. Despite my attempts to believe that my roles as a pediatrician and a parent do not influence each other, the truth is that they are deeply …

Returning the joy of medicine to our primary care physicians

Christopher Crow, MD, MBA

Physician

January 10, 2023

Nearly 50 years have passed since the first published mention of physician burnout. Clinical psychologist Herbert Freudenberger described the “excessive demands on energy, strength or resources” and wrote of how it resulted in “fatigue, frustration, cynicism.” And though initiatives, programs, and solutions to address burnout have grown, the concerns first cited in 1974 have grown as well—now reaching the undeniable crisis.

In a recent survey, 61 percent of physicians reported …