A Country Doctor, MD

Author's details

Name: <a href="https://www.kevinmd.com/blog/post-author/a-country-doctor" rel="tag">A Country Doctor, MD
Date registered: November 21, 2017
URL: https://www.kevinmd.com/blog

Latest posts

  1. Suboxone for pain makes sense. Why don’t more doctors prescribe it? — November 19, 2018
  2. Doctors overcorrect too often — November 12, 2018
  3. We need more behavioral health treatment in primary care — November 8, 2018
  4. Transdiagnostic therapies in primary care — October 30, 2018
  5. When patients can’t tell you their symptoms — October 24, 2018

Author's posts listings

Suboxone for pain makes sense. Why don’t more doctors prescribe it?

Many patients who end up in Suboxone treatment have chronic pain. They were originally prescribed other opiates and ended up addicted to them. Skeptics argue that is just substituting one opiate for another. But that isn’t quite accurate. More on that …

Doctors overcorrect too often

Back when cholesterol target numbers ruled unopposed (before 2013), we all checked fasting lipids every three months. Before 2012, we also checked liver function quarterly in hapless riders on the cholesterol pill merry-go-round. That year the FDA anno…

We need more behavioral health treatment in primary care

I don’t know how many times a patient has told me, “I was in therapy once, and it didn’t help.” My response is always: “That’s like saying ‘I saw a movie once and I didn’t like it’.” That usually breaks the ice just a little. In primary car…

Transdiagnostic therapies in primary care

I learned a new word recently: transdiagnostic, which refers to something that is applicable across a spectrum of conditions. It seems that this is becoming an increasingly popular concept in treating anxiety disorders. No wonder. As I researched this …

When patients can’t tell you their symptoms

Today I had a followup appointment with a young adult male with severe intellectual disabilities. He is barely verbal. Several weeks ago his caregiver told me that this young man often pointed to his chest and would say “hurt” or “heart,” they weren’t sure which. He also seemed to have gotten pickier about his food, […]

Primary care does what Google can’t

Non-clinicians skip over some of the most necessary underpinnings of doctoring and speak too much about housekeeping issues: blood pressure targets, aspirin use, mass screenings, immunization rates and so on. People without medical degrees could do those things. But there are steps that must be taken before we worry about the measurables. These are the […]

Medicine is a word with 3 meanings

Everybody is a stakeholder these days in what we broadly call medicine, or health care. But there is little agreement on what medicine is and what the priorities of the health care “industry” should be. I propose this breakdown of medicine into three separate phenomena. 1. Micromedicine 2. Macromedicine 3. Metamedicine Let me explain: Micromedicine: […]

It’s the physician’s job to think of worst-case scenarios

I saw two patients with a chief complaint of bubbles in their urine this month. One middle-aged woman had eaten some wild mushrooms she was pretty sure she had identified correctly, but once her urine turned bubbly a few days later, she came in to make sure her kidneys were OK. Even though she was […]

A case of instant gratification in primary care

Few things in primary care give patient and doctor mutual and instant gratification. It’s been a while since I reduced a “nursemaid’s elbow” or a spontaneous shoulder dislocation other than my own, or a finger dislocation, but those all count. I once wrote about curing deafness in a man with a movement disorder by flushing ear […]

Real doctoring means mitigating the fear patients have

It’s been said in the world of business that people only buy two things: good feelings and solutions to problems. In medicine, the single most important factor that brings patients through our doors isn’t a “toward” kind of desire, but an “away” one — away from feeling bad. More specifically, it is pain and fear […]

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