Category: primary care

Why are we treating outpatients like inpatients?

Repercussions. Every action that is taken, especially when it comes to healthcare, has ripple effects, which often end up being more far more significant than we anticipate, turning that ripple into a tidal wave. Every time somebody besides actual health care providers steps into the mix and tell those of us taking care of patients […]

The social determinants of a physician’s path

Poverty is known to be an important determinant of a person’s health and longevity. A person’s zip code is more relevant than genetic code. Does a physician’s zip code – that is where they were born and raised – have an effect on where they practice? Specifically, do rural born and raised physicians return to […]

The satisfaction of Suboxone treatment

My second foray into Suboxone treatment has evolved in a way I had not expected, but I think I have stumbled onto something profound. Almost six months into our in-house clinic’s existence, I have found myself prescribing and adjusting treatment for about half of my medication-assisted treatment (MAT) patients for co-occurring anxiety, depression, bipolar disease […]

Reading the body language of your patients

When a patient is unwell and seeking help, a vast number of emotions could be going through their mind. Their whole life could have been turned upside down, they may have been fearing this moment for a while, and stressing over the implications of their illness. To physicians, it may sometimes feel like just another name […]

Why do so few doctors treat people with opioid addictions?

Dear Doctor, Please help me understand why so few of you have chosen to treat people with opioid addictions. I’ve been following the topic of opioid addiction for years. It is one of the most common themes for First Opinion submissions. Authors routinely point to the importance of medication-assisted therapy, the standard of care for individuals with opioid […]

Pronouns matter: How we can do better in LGBTQ patient care

In the wake of Pride Month, I have been reflecting on how our health care system impacts the lives of individuals with identities across the gender spectrum. Sometimes, when sending a prescription to a pharmacy for any given patient, we will get a phone call that the date of birth on file with insurance does […]

10 ways to stay out of the DEA’s crosshairs

No news attracts attention like a physician who’s in trouble with DEA or their state medical board. So, how does it happen, what are the common issues and what can a physician do to safeguard themselves? First, let’s look at what the numbers and the research tell us. The Federation of State Medical Boards (FSMB) […]

A physician’s warning on the keto diet

The keto diet has recently garnered much fame for its apparent ability to improve diabetes and obesity – results so impressive the Journal of the American Medical Association recently highlighted the diet and thereby christened it as something more than a low-carb craze. However, not all the evidence supports such a positive outlook, leading the […]

Don’t worry, medical students don’t judge

Everybody gets nervous at the doctor’s office. Physicians ask all sorts of personal questions about what people eat, how much they drink, and how things are at home. Even questions that would seem completely harmless in another context — such as how work is going, or what hobbies a person enjoys — seem surrounded by […]

How today’s EMRs are like self-driving cars

Drivers are distracted klutzes and computers could obviously do better. Self-driving cars will make all of us safer on he road. Doctors have spotty knowledge and keep illegible records. EMRs with decision support will improve the quality of healthcare. The parallels are obvious. And so far the outcomes are disappointing on both fronts of our […]