I didn’t become a primary care doctor to treat opioid addiction. I wasn’t trained for it. To be honest, it scared me. But when you work, like I do, at a clinic that serves a lot of people who have little money or who struggle with mental health and sub…
Apocryphal story from residency: On morning rounds in the critical care unit, the post-call resident starts to present a complicated patient admitted overnight with chest pain, and after the first bits of the history have been presented, the wise old c…
I see several patients daily with cancer. Some days can be tough, but nothing compares to what they are going through. I know that. The physical anguish and toll that chemotherapy, radiation, and surgery can take on the body. The burden that the diseas…
First, the cancer diagnosis. Then, the barrage of trite encouragements: You can beat this! Don’t give up. Keep fighting! It’s not only friends and family members who utter these clichés — usually at a loss of what else to say. Health care providers als…
My elderly patients miss the days when, in an emergency, they could call their family doctor at home, and they’d be cared for. Retired doctors reminisce about the “good old days” when they were in charge of their own schedules and could prescribe whate…
When a patient goes to the doctor, they usually have a specific health problem in mind. Sometimes, the treatment is straightforward; a urinary tract infection warrants antibiotics. A laceration can be sutured. Other issues, however, are more complex. F…
I have been practicing telemedicine successfully for four years. In 2015, I had to beg doctors to work in telemedicine. Because so many doctors were wary of it, I started to get licensed in multiple states, and now, I have 15 state licenses. Well, what…
To treat any condition, the doctor needs to know what it is. You would not expect to have your sore ankle treated with penicillin or to have an appendectomy recommended for your sore throat. While this may be self-evident, I know of at least one patien…
Being a primary care physician, I was afraid to start my own practice. There was discouragement from fellow physicians, hospital leaders, business colleagues, and even patients. Many said that the small practice model was not viable. With insurance man…
In my clinical practice, I have encountered patient aggression typically with narcotic medications, in particular with the refusal of a refill due to evidence of concerning behavior, like a positive drug screen for drugs not prescribed. Aggressive beha…
