In academic medicine, promotion depends on the weight of our curricula vitae, measured primarily by the number of papers we publish in peer-reviewed journals. Physicians strive to jump through the hoops of publishing their work in “top” journals ranked by the “impact factor” (yearly average number of citations for a given journal). Yet the “impact […]
Category: primary care
EHRs are killing medical innovation
To paraphrase Bill Gates: “The purpose of humanity is not just to sit behind a counter and do things. More free time is not a terrible thing.” I have innovated. I developed a mutation assay. I discovered that vacuum ultraviolet light from excimer lasers is safe to use on human tissue. I invented an imaging […]
Explaining what osteopathic medicine is
First of all, many osteopathic medical schools are located in underserved areas — or as underserved as possible while still having enough of a medical community to make training possible. My school, LMU-DCOM is located in the middle of Appalachia, for example. Osteopathic medical schools generally encourage students to specialize in primary care, at least […]
Care but don’t touch: Being wise in the modern era
The medicine I practiced between 1974 to 1992 is gone. Evidence is the coin of the realm in the courts of modern medicine. The rule “first, do no harm” demands a corollary — be paranoid. We receive extensive training and licensure to “touch” patients. Any person who is not a physician who cuts into another […]
Take a close look at the number of opioid pills you’re prescribing
Recently, a generally healthy friend of mine had two small, unrelated surgeries over the course of a few months. For the first, a small operation on his hand, he received a prescription for 30 oxycodone pills. He used one the night after surgery, to make sure pain wouldn’t wake him. Over the next few days […]
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 […]
How to ease men’s fear of mentoring in medicine
There has been a recent surge in discussion about men’s fear to work alone with female colleagues in medicine. This reluctance puts both men and women at a disadvantage. Women are being excluded from career opportunities and men are missing out on the benefits of collaboration. As a victim of sexual misconduct during my own […]
Stop stigmatizing medication-assisted treatment
Imagine yourself as a patient burdened with a chronic disease that necessitated daily medication adherence to function. Now imagine that medication has become so stigmatized by society that you feel judged and ashamed every time that you use it. That’s the world that individuals with opioid use disorder are forced to live in when they’re […]
Evening eating: Are you a “light” eater?
An excerpt from Let Go of Emotional Overeating and Love Your Food: A Five-Point Plan for Success. Copyright © 2018 by Arlene B. Englander. Published by Rowman & Littlefield. All rights reserved. Anyone who has ever tried to lose weight or keep weight off realizes that evening can be the make or break time of […]