A Health Affairs blog post titled “Fixing Clinical Practice Guidelines” echoed several concerns I’ve discussed previously: practice guidelines are being produced in abundance but often have variable methodological quality, financial c…
Category: primary care
How can we address retention in the era of physician burnout?
As we’ve seen, the lives of those working in the health care system has become overwhelmingly challenging, burdened by all of the excess nonmedical stuff that has been added into our lives as we try to take care of patients. From prior authorizat…
Here’s what true grit looks like in health care
As a medical director and practicing physician, I count myself fortunate to meet and engage in meaningful conversations with many health care professionals throughout the state of Pennsylvania. Recently I was both humbled and inspired when I visited wi…
A primary care physician’s decisions are questioned and second-guessed daily
A 67-year-old woman with a high-stress job had a vigorous disagreement with her neighbors last week. She developed severe substernal chest pain and called 911 fearing a heart attack. She is thin, has never smoked, has normal blood pressure and normal c…
Doctors have little clue about what actually goes on in their colleagues’ offices
When I meet patients in the office, our conversations do not focus exclusively on the medical issue at hand. Of course, if you come to see me with a stomach ache, at some point, I will direct the dialogue toward your abdomen. Often, our conversations a…
What to consider before undergoing stem cell treatment or banking stem cells
It can be difficult to tease out the evidence-based science amidst the claims of successful adult stem cell-based treatments for a range of health problems from joint pain to Parkinson’s disease, macular degeneration, and spinal cord injury. Even a num…
The sensitive topic of physical contact during exams
Touch is a sensitive thing. No pun is intended here, but whether and how we touch our patients deserves our careful thought and deliberation. So much interpersonal contact these days is virtual, with emojis, abbreviations and whole words thrown around …
More than three hours late, but somehow still on time
The sound of a clock, hung haphazardly on a colorless cold wall, ticks repetitively — tick, tick, tick. Time continues to pass as my appointment scheduled for three hours ago seems like it will never come. I scheduled this appointment three month…
Should doctors give up on primary care?
Ten years ago, I wrote an essay on the primary care shortage. I argued that more money and better working conditions would help decrease the shortage. Unfortunately, things have worsened over the last decade. The AAMC now predicts a shortage of betw…
A physician’s first telemedicine video visit
I just did my first telemedicine video visit. The concept seems so strange, the idea of carrying out an “office visit” without the patient actually being in the office. Right now we have it structured so that when a patient calls up request…
