Locum tenens (literally "place holder") is professional work done to fill in where help is needed. It is what I have primarily been doing for the last year, and has been an interesting ride. When I decided to leave my practice related to losing a couple of partners and wanting to update my knowledge base and re-evaluate my career, I decided to do locum tenens work. I had always thought that ...

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shutterstock_120254749 As with any disease, prevalence of this narcotics abuse is region-specific; an hour north of the office where I practice, Rio Arriba County in New Mexico is home to one of the highest opioid overdose rates in America - up to five times higher than the national average.  Our patients routinely lose family to addictions; our clinic has been home to a ...

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Would it be silly to ask, “Is the history and physical examination worth performing anymore?” especially in this era of high-technology medicine? Does it matter if the diagnosis is made by the bedside in contrast to CT or echocardiography? Someone did ask, and the answer is intriguing and was debated. Let’s look at the data. Four hundred and forty-two consecutive patients were admitted from the emergency department to an ...

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Do you read the comic strip Dilbert” by Scott Adams?  I read it most every day.  It tells the story of an engineer named Dilbert and the people with whom he works, including notables such as Wally, Alice and the pointy-haired boss.  Mr. Adams daily relates amusing situations of the dysfunctional relations at Dilbert’s work site.  While the situations are hilarious at times, they reflect the actual work processes at ...

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There’s certainly a lot of buzz surrounding the word “holistic” in the field of medicine lately.  For the purposes of what I am talking about in this article, I assume that all, or at least most, doctors take a holistic approach to medicine.  Meaning that they can think across many of the body’s systems, understanding how one condition or component affects the others, and considering each aspect of a patient’s ...

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As a physician, do you care enough about your patients? It is my belief – and my experience – that physicians care deeply in ways that we demonstrate through our hard work, our commitment, and our willingness to go beyond the ordinary almost every day of our professional lives.  What often gets “lost in the soup” of busyness is the communication of that caring in a mindful, purposeful and comfortable ...

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shutterstock_114468898 “Look at all those beautiful little white flowers,” I said to my wife. “I don’t remember seeing them there before.” In the neglected ten-by-thirty foot corner of our garden, a crop of white flowers began to emerge toward the end of the summer. “You never saw them because they are weeds,” my wife said. “What do you mean … weeds?” I asked. “They are beautiful!” “Weeds ...

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Once upon a time a doctor first attended 3 or 4 years of college, then finished 3 or 4 years of medical school, trudged through 1 to 8 years of residency training to hang out “a shingle,” and finally begin to practice medicine, usually in solo practice.  Those days are long gone.  Time has expanded—schooling and training are longer. Breaks are taken between and during this once but no longer traditional ...

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Even doctors must become patients eventually, and often challenging patients at that.  We know enough to be dangerous but not enough to be in charge.  We want to question everything but try not to.  We can tend to be catastrophic thinkers because that is how we are trained to be, but fear being alarmists.  We want our care providers to actually like us, when we know they inwardly cringe knowing ...

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shutterstock_94210177 “I’d really feel better if we got the MRI,” Ms. James said. “I understand you think it’s a migraine, but I want to know, just in case. Wouldn’t you?” Ms. James and I sat in her darkened hospital room—the light bothered her eyes and exacerbated her headache. She was a dialysis nurse with many years of experience in the healthcare field, and I ...

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