Primary Care

Why gardening is the best medicine

Physician

August 18, 2020

My first glimpse into the power of urban gardening was not through bucolic farmer’s markets or verdant nurseries, whose beauty I only came to after medical school. My introduction was in our small suburban backyard of clay soil. My dad planted silvery, wild-armed globe artichokes, because they could produce flower buds and leaves we could eat, to improve our digestion. That glimpse was enough to ignite my curiosity about homegrown …

Read more…

Why gardening is the best medicine

How physicians can find jobs in the pharmaceutical and biotechnology industries

Nerissa Kreher, MD, MBA

Physician

August 18, 2020

Fifteen years ago, my career path took a detour. As a two-physician household, we were managing my husband’s match and my job interviews in the cities he was considering. Boston, Milwaukee, and Los Angeles – could you get any more diverse? Definitely, an awkward way to interview; hard to sell excitement when it was clear that it really depended upon “the match.”

Boston! As soon as we got the match results …

How to recruit more students into family medicine

Kenneth Lin, MD

Physician

August 16, 2020

In 2019, a Policy One-Pager produced by the Robert Graham Center reported that the percentage of the active U.S. physician workforce in primary care practice declined from 32 percent in 2010 to 30 percent in 2018. Although family physicians represent 4 in 10 primary care physicians, in several states, a large percentage of family physicians are older than 55 years and anticipated to …

4 ways to decrease your dread of being on-call

Katie Townes, DO

Physician

August 15, 2020

Have you ever been faced with an upcoming shift at work and felt an impending sense of doom? This type of anticipation can be a real killjoy. However, taking calls, working nights, weekends, and holidays is all part of the job, right?

Worst. Call. Ever.

I was just drifting off, entering the first phase of sleep when the whole body is relaxed, and you’ve entered that sweet twilight zone. …

Fascia in primary care: When chest pain is not in your chest

Cathy Kim, MD

Conditions

August 11, 2020

“Imagination is more important than knowledge. For knowledge is limited to all we now know and understand, while imagination embraces the entire world, and all there ever will be to know and understand.”
– Albert Einstein

“Mr. Thomas, are you OK? Sir, are you OK?” It was a full clinic day, and I had just improvised a treatment on him.

I had met this patient, “Mr. Thomas,” only once before. After meeting me …

Doctors: Never pass judgment on the human being in front of you needing help

Suneel Dhand, MD

Physician

August 11, 2020

Oh, how we all learn and change with our experiences. It’s one of the greatest things in life that most of us (hopefully) are not the same person now that we were a few years ago. Looking back to when I first become a physician at the age of 22 (yes, that’s the typical age that most medical students across the world become doctors, because medical school comes straight after …

Doctors are fleeing the medical field. Here’s why.

Anna Gladstone, DO

Physician

August 10, 2020

The first day I started work as an attending physician in primary care medicine, I knew I had made a terrible mistake. This was not the heroic, selfless, service-oriented job or the romantic life “as seen on TV” I had imagined.

Riddled with heavy school debt, despite my best efforts to join debt relief programs, I had a frustrating job with nothing but red tape and hurdles to jump over. And …

There is endless profit potential to treat chronic diseases

Hans Duvefelt, MD

Conditions

August 8, 2020

I have noticed several articles describing how antibiotic development has bankrupted some pharmaceutical companies because there isn’t enough potential profit in a ten-day course to treat multi-resistant superbug infections.

Chronic disease treatments, on the other hand, appear to be extremely profitable. A single month’s treatment with the newer diabetes drugs, COPD inhalers, or blood thinners costs over $500, which means well over $50,000 over an effective ten year patent for each …

Is upspeak really that bad for women in medicine?

Joan DelFattore, PhD

Physician

July 25, 2020

A few weeks ago, I was delighted when KevinMD accepted an opinion piece I’d submitted. But I withdrew it just before publication because, on reflection, I realized that I’d been wrong.

While sheltering in place during the COVID-19 pandemic, I’ve become an avid consumer of medical podcasts, such as those presented by JAMA and the New England Journal of Medicine. The opinion piece …

Don’t be afraid to say “Black” when asking about someone’s culture

Arindam Sarkar, MD

Physician

July 9, 2020

On the morning of George Floyd’s funeral less than ten miles from our medical center in Houston, I was avoiding the word “Black.” Despite wholehearted pride in the strong Black presence in our community health center’s physicians, staff, and patients, I felt a loss of words that Tuesday morning. There was simply too much pain, grief, and rage in our community.

I was thankful …

Primary care is dying: Why that should scare every large employer

Elizabeth Mitchell

Policy

July 6, 2020

Primary care is on life support. COVID-19’s toll on American health care extends beyond the hospitals and medical workers besieged by infection. An equally insidious but less-visible crisis is engulfing primary care, the long-neglected foundation of our health care system. Given the role of America’s largest corporations in providing health care benefits, the C-suite should be on high alert.

As growing numbers of patients postpone appointments over concerns about …

10 telemedicine billing questions and answers that are relevant right now

Clint Phillips

There’s a code for pain, but what’s the code for suffering?

Hans Duvefelt, MD

Conditions

June 16, 2020

Opiates relieve pain and can transport people to their apparent happy place. So does marijuana. Lyrica, the seizure-turned-pain medication, caused enough of a buzz in early study participants that it became a controlled substance. The anesthetic ketamine is now used for treatment-resistant depression.

Years ago, we had to be very specific about the location and classification of our patients’ pain. When pain then became a self-reported vital sign and chronic opioid …

How MOC is contributing to the demise of physicians

Torie S. Sepah, MD

Physician

June 5, 2020

Let me start by saying that I am a diplomate (i.e., “board-certified”) by the American Board of Psychiatry and Neurology. I was completely in agreement that to display competence in my specialty after four years of residency, I should pass the oral and written exams required by the ABPN, further to prove I have maintained my skills, I have always found it …

Does the EMR improve or worsen patient safety?

Danielle Ofri, MD, PhD

Physician

June 2, 2020

An excerpt from When We Do Harm: A Doctor Confronts Medical Error.

One of the selling points for the electronic medical record (EMR) was that it would be a boon for patient safety. Just having all the medical records in one place is a monumental improvement over …

What can patients do to lower the risk of errors in their electronic medical records?

Miles J. Varn, MD

Physician

May 17, 2020

In a perfect world, an electronic medical record would aggregate a patient’s medical information from all health care providers into a single, comprehensive record that could be easily accessed by any provider with the patient’s permission. This information could reduce the risk of medical errors, duplicate testing, and inappropriate treatment and the associated cost of these mistakes. It could also be lifesaving in the event of a medical emergency that …

A story of a family physician looking for work during the pandemic

Anonymous

Physician

May 6, 2020

I never expected to find myself in this position. Ironically, I, a family medicine physician, in a world grappling with a pandemic, became underemployed for the first time since high school. A unique set of circumstances led me to this situation, but it turned out to be far more challenging for me emotionally than I expected.

At the end of 2019, I made a decision to leave my regular job as …

The patient who no-shows

Erin Hoffman, DO

Physician

May 1, 2020

“Your patient just had their 6th no-show, this exceeds our policy limit, please call to investigate barriers to care, also we recommend formal dismissal from the clinic.”

The message regarding one of my obstetric patients was waiting when I opened my inbox this morning. In our primary care office, we have a policy regarding “no-shows”: Patients who miss a scheduled appointment without calling ahead to cancel or reschedule. Three strikes and …

Read more…

The patient who no-shows

A physician leaves concierge medicine after 13 years

Annie Moore, MD, MBA

Physician

March 20, 2020

Much is written about the advantages for primary care physicians and patients of working within a retainer model, direct primary care, concierge-type care model. Little is written about the downside or disadvantages. It is time to shine a light on the benefits and challenges of concierge and standard models through an experienced lens, particularly as drivers of burnout and the primary care shortage loom so large. The phase of a …

Dear patients: Please show up on time

Katie Klingberg, MD

Physician

March 9, 2020

There is constant tension to remain on-time working in a primary care clinic, seeing patients every twenty minutes back-to-back. It takes an incredible ability for the front desk staff, medical assistants, and the physician to be able to keep this flow running smoothly only to have it be derailed by the late patient who does not understand how their actions affect everyone else after them.

I currently work in a system …

Read more…

Dear patients: Please show up on time