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 […]
Category: primary care
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 […]
Do opioid contracts harm the doctor-patient relationship?
A contract is an agreement stipulating the rights and obligations of the signatories. In most cases, a contract is consulted when a dispute arises. When all is proceeding swimmingly, the contract remains dormant in a file drawer or in a digital file. In general, decent people resolve differences in the old-fashioned way utilizing the twin […]
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: […]
A scrum master for primary care
We should consider a new position in our primary care teams — that of the scrum master. “Scrum” is a rugby term that comes from agile, a work methodology for software development that now is being applied to industry and health care. In rugby, a scrum is a huddle where the teams come together with […]