As a physician in a rural health clinic, I frequently see patients who complain of anxiety. The majority of these patients are in their 20s to 40s. Some have never been evaluated by a mental health professional, and many of these patients take benzodiazepines on a chronic basis. After current review, I wonder if we as primary care physicians are good at treating anxiety, or are we contributing to drug ...

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Prescription labels need to come in languages other than English As the saying goes, "With great power comes great responsibility." That applies to physicians when prescribing medications, but it also should apply to pharmacies when they're dispensing medications. In December, after seven years of exams, lectures and rounds, I received my medical license. Finally, I had the power to prescribe medications without the co-signature of my supervisor. "Be careful," she advised, "remember the ...

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In America, the conventional wisdom is that we don't ration health care. But we do, and there's no better example than patients rationing themselves when it comes to the medicines they take. Recently, a young twenty-something I know had a nagging cough—seasonal allergies, her doctor said and prescribed a generic medicine for asthma and allergies. She did not fill the prescription—the $160 price tag was too steep. Although she had health ...

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One of the things that used to make physicians different from other providers is the ability to prescribe drugs.  This is not true anymore, but the majority of prescriptions are still written by doctors.  Prescribing practices of physicians vary widely across different populations and specialties.  If a doctor takes Medicare patients, his prescribing patterns are part of the mountains of data Medicare collects about it’s patients.  In 2003 the government ...

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From time to time I get asked about cleanses. What is typically meant by a “cleanse” is only drinking a juice concoction for several days. Some cleanses add things like cider vinegar, cayenne pepper, or other supposedly “healthy” substances. The most common reasons to “cleanse” that I hear from people who drink these things include:

  • Lose weight
  • Feel better
  • Remove “toxins”
Let’s start with weight loss. Cleanses are very low calorie and don’t contain protein ...

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I had been laid off a few months when my ulcerative colitis kicked in, and my doctor and I struggled to get it under control.  After trying a variety of medicines, my health continued to deteriorate and I agreed to take Remicade. Remicade is a potent drug, administered through an IV infusion at the oncology center that comes with a whole host of potential side effects.  The dosage requires an initial ...

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We want teens to know about emergency contraception The FDA announced recently that it is approving Plan B for all girls age 15 and up without a prescription. This is good news for girls in the US of A. The easier the access to contraception, the less likely girls will have an unintended pregnancy. As many as 80% of pregnancies in teen girls in the United States are unintended. Most pregnancies ...

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Can coffee help you live longer? If you drink coffee, I have some bad news and some good news. The bad news is that the more cups of coffee you drink, the higher your risk of dying early. The good news is that if you "risk adjust," then the more cups of coffee you drink, the lower your risk of dying early. Let me explain. According to a
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This is a call to arms to my fellow providers to protect our patients from themselves and our willingness to comply with their requests.  We live and practice in a society filled with fear of medications and their side effects.  People will not take blood pressure, cholesterol, or diabetic medication because of the side effects they have heard or read about. However, these same patients will take antibiotics every day of ...

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After a terribly painful and debilitating illness, Steve died.  He had been treated for Stage 2 Hodgkin’s Disease with a series of intense therapies including German enzymes, American antineoplastins, Mexican naturopathy and Chinese herbs, complemented by focused meditation, innumerable vitamins, extreme diet modification and acupuncture for severe pain.  He fought the cancer with every ounce of his being, doing everything to survive, except the one thing that had an 85% ...

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