Primary Care

Physicians writing on KevinMD about the primary care shortage, the fifteen-minute visit, panel size, what primary care is paid against procedural specialties, continuity, and the administrative load that has grown around the work. Four maintained records draw on this archive: Primary care: what physicians say, in their own words, Direct primary care: what physicians say, in their own words, Prior authorization: what physicians say, in their own words, and Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words.

Fairness in medical publishing: Reforming the peer review process

Andrew Spector, MD

Physician

November 8, 2020

In the middle of a busy week of balancing clinical, research, educational, administrative, and parental responsibilities, I receive an email request from a prominent journal to review a manuscript. If I agree, I will spend a couple of hours reading the manuscript, offering comments, and registering my opinion. Several weeks later, I’ll probably be asked to review an edited version all over again. And in exchange for this effort? Nothing. …

Let us not forget that patients were young once and have stories we need to hear

Andy Lamb, MD

Physician

October 31, 2020

He reminded me of a pit bull, this sometimes cantankerous but always fascinating World War II veteran. We first met in 1992, shortly after I arrived in Burlington following my years in the Army. Chronologically he was in his early 70s, but physiologically he was years younger. Square-jawed, short and stocky with broad shoulders, and muscular, tattooed arms, I easily envisioned a once physically imposing, rakishly handsome, young man. For …

An appreciation for the sacred spaces at work

Anthony Fleg, MD

Physician

October 29, 2020

As a healer who has been doing my work in the dark, blind in a sense, today was a big day.

The visit was scheduled, not as a phone visit but as my first Zoom visit since the pandemic began 150 days ago. Usually, I see about 30 patients in-person a week. During the five months of COVID, I have seen about 30 patients in-person total, with the remainder conducted entirely …

A DO’s take on the FIGS faux pas

Kristina Scanlan, DO

Physician

October 23, 2020

Most health care providers are aware of the FIGS scrubs advertisement that depicted a female physician with a DO badge holding a Medical Terminology for Dummies book upside down. In one fell swoop, FIGS enraged the entire medical community causing backlash towards their company. This ad mocking female osteopathic physicians sparked outrage. Many in health care have vowed not to purchase FIGS, prompting the #boycottFIGS response posted as a result …

Read more…

A DO’s take on the FIGS faux pas

2 stories that remind us to find joy and creativity in our new normal

Anthony Fleg, MD

Physician

October 21, 2020

“Hope things go back to normal soon.”

That was the text I received from a friend yesterday. It struck me in reading those words that I have stopped thinking or worrying about the end of the pandemic. In those first months, absolutely. Daily thoughts of getting back to normal life.

Now, out of self-preservation and a renewed sense of life’s sacredness and fragileness, I have turned to making the most of each …

A patient makes this doctor realize the preciousness of time

Andy Lamb, MD

Physician

October 21, 2020

He was in his 30s, strikingly handsome with the short-cropped hair of a soldier. This was Ukraine, and it was at war with Russia. He was now part of that war, a war the rest of the world has forgotten or no longer cares about, even as its’ young men continued to fight and die in the horror that is the front-line. His unit’s chaplain asked me to see him …

Expanding the osteopathic concept for the health of all things

Amelia L. Bueche, DO

Physician

October 20, 2020

To be seen.

To be heard.

To be understood.

To be acknowledged.

To be appreciated.

To be accepted.

To be welcomed.

To be engaged.

To be involved.

To be worthy.

To be helped.

Common desires of patients.

Common desires of physicians.

We are all interrelated.

This is the foundational basis of osteopathic medicine. Whether …

Make music out of the sounds that life presents

Anthony Fleg, MD

Physician

October 16, 2020

Way back when humans listened to music without Spotify, AirPods, or smartphones.

In those BSP (before smartphone) days, people would actually get off their tooshies (the medical term for the gluteal area) and walk over to a thing called a stereo to adjust the sound using something called an equalizer. Crazy huh? Millennials reading this are already distractedly Googling all of this to verify I am not spinning tall tales.

Let’s use …

Attacks on osteopathic medicine are attacks on all physicians

Joshua D. Lenchus, DO, RPh and Bradley Flansbaum, DO, MPH

Physician

October 15, 2020

It was distressing to hear and read recent and ongoing disparaging comments about osteopathic medicine, attacking one of our own, from remarks by Rachel Maddow to tweets by Cher and a derogatory video, since removed, portraying a female DO by Figs Scrubs.

Navy Commander Dr. Sean Conley, DO, serves as the Physician to the President. This emergency medicine-trained combat veteran graduated from the Philadelphia College of Osteopathic Medicine and is well-qualified …

Conversations are the best ways to overcome concerns

Steven Reznick, MD

Physician

October 14, 2020

When I organized my medical practice, I tried to find individuals with great customer service skills and medical knowledge to work in internal medicine practice. We all do our best to meet the needs of our patients, but sometimes, even with the best of efforts, we fall short.

For example, a patient requested a large quantity of a medication as a refill early one morning. I saw the fax as I …

Doctors already are actors, whether they want to be ones or not

Suneel Dhand, MD

Physician

October 13, 2020

The era of the empowered patient and patient-centered health care has been upon us for some time. Only a generation ago, there was a much more paternalistic approach to medicine. This has changed for the better across the western world. As somebody who teaches and coaches physicians on how to improve their communication skills, I would say that the newer generation of doctors is much more receptive than many of …

The Greatest Generation is dying out. It’ll really be our loss once they leave us.

Suneel Dhand, MD

Physician

October 11, 2020

As a physician working in acute care medicine, one of the biggest delights of my job is regularly still having patients from the Greatest Generation. In the United Kingdom, I really enjoyed sitting with them and hearing their stories of mandatory city evacuations during World War 2, rationing, the Blitz, and the huge struggle to rebuild a devastated country after 1945. Visiting my grandparents in India when I was a …

It is time to acknowledge the caretaking abilities of men

Deborah Edberg, MD

Physician

October 11, 2020

Several months into the pandemic, I received a call from a troubled resident. She had been pulled from her inpatient rotations and was working remotely from home with her husband and one-year-old child. Shortly into our conversation, she confessed the guilt she was feeling at not enjoying the enhanced alone time she now had with her baby. She was instead mostly anxious about the learning experiences she was missing, and …

Telemedicine for proficient, longitudinal management of chronic conditions

John H. Wasson, MD

Physician

October 11, 2020

Chronic conditions are justifiably an area of broad concern because of their adverse impacts on patients and effects on health care costs. Recently, the COVID-19 pandemic has drawn attention to the role of telemedicine as a powerful tool for revolutionizing chronic condition management. Going forward, the policy question is whether clinicians should have complete flexibility as to when and how often to substitute telemedicine services for …

5 situations when you should get a second opinion

Miles J. Varn, MD

Physician

October 10, 2020

A second opinion can be a powerful tool. It can help lower your risk of experiencing a medical error or misdiagnosis, allow you to explore all treatment options and their benefits and risks, connect you with physicians who have experience and success treating people with your diagnosis, and provide peace of that mind that your diagnosis and treatment plan are appropriate.

Research from the Mayo Clinic highlights the value of second …

Meet the physician who loves his job

Hans Duvefelt, MD

Physician

October 9, 2020

I only applied to one medical school. Maybe that was hubris, but I didn’t think so at the time. Then, in a moment of sudden insecurity, I asked myself, “What if I don’t get accepted?”

During the six months between my military service and the beginning of classes at Uppsala University, I worked as a substitute teacher in my hometown, teaching second to eleventh grade depending on where there was a …

Read more…

Meet the physician who loves his job

Giving little moments of joy reminds us of the human side of medicine

Andy Lamb, MD

Physician

October 9, 2020

The cab driver pulled up to a small house, typical of the post – WWII era. He honked his horn and waited. He honked a second time, but no one came. He contemplated leaving, as it was near the end of his shift, but decided to go knock on the door. Through the door, he heard a voice and something scraping across the floor. The door slowly opened and a …

Put nutrition counseling in primary care

Melinda Mesmer, MD

Conditions and Diseases

October 8, 2020

The United Nations designated 2016 to 2025 the “Decade of Action on Nutrition” in recognition of the growing importance of food and diet as it relates to all aspects of human health. We’re almost halfway through, and we’re not making the progress we need to.

A comprehensive study of scientific evidence for global diet goals and sustainability, the EAT-Lancet Commission Summary Report, stated, “Read more…

Put nutrition counseling in primary care

Primary care pearls from trending CME/CE courses on Pri-Med.com

Pri-Med

One physician’s journey from burnout to bliss reveals the creative muse in all of us

Lara Salyer, DO

Physician

October 5, 2020

An excerpt from Right Brain Rescue: One physician’s journey from burnout to bliss reveals the creative muse in all of us.

I was about to perform reconstructive surgery, to change someone’s life forever. My hands were posed above the body, and my knees felt wobbly. I inhaled …

Primary Care

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