Category: primary care

Genetic testing: Could there be unintended consequences?

Both clinical and direct-to-consumer genetic testing have become significantly less costly and more common, providing people with access to a wealth of information about everything from their ethnicity and family lineage to their risk for certain disea…

CMS needs to permanently eliminate barriers preventing routine use of telemedicine

On March 6, 2020, the Centers for Medicare and Medicaid Services (CMS) provided a temporary waiver to expand telemedicine services, whose use was previously limited to specific circumstances. However, as the United States grapples with the unprecedente…

How COVID-19 affects this family physician at work and at home

I am sitting at my kitchen table. To my right is my daughter, 9; to my left, my son, 11. They are drawing, reading, doing work that their teachers have diligently sent electronically. Between quiet stretches and fighting between my kids, I try to keep …

The small practice primary care response to COVID-19

I am scared as I sit down to write about our journey as a small practice as we fight along with the rest of the world against the unthinkable force of nature in the form of a COVID-19 pandemic. My small primary care practice is only two years old. In a…

Lessons from evolution of telemedicine in response to COVID-19

The COVID-19 pandemic has threatened our physical and mental health and the very fabric of society. Social isolation has devastating consequences on small businesses, but it has also opened doors to remote business opportunities in the virtual world. M…

It took a pandemic to realize the value of telemedicine

It took a 125-nanometer virus only a few weeks to move American health care from the twentieth to the twenty-first century. This had nothing to do with science or technology, and only to a small degree was it due to public interest or demand, which had…

A physician leaves concierge medicine after 13 years

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 …

Independent practice and the lost art of touch

I am a geriatric psychiatrist and am an osteopathic physician. The art of touch is a major part of my practice. I am the medical director of an inpatient geriatric facility. The patients that I see on the unit are typically suffering from dementia with…

The vast ethical void between primum non nocere and the customer is always right

First, do no harm. For physicians, these are hallowed words. Within religion, they are akin to the Golden Rule and are, in fact, quite similar. In the realm of ethics, Kant’s categorical imperative, to only do what you would have seen done universally …

On-demand doctors: Are we becoming medical waiters?

Seven years ago, I vividly recalled a patient saying, “It needs to be as easy to schedule with you as OpenTable.” For most health care systems, this request is now a reality. Yet, how far has the restaurant metaphor moved into patient expec…