I believe that family medicine is the solution to American health care. I believe that family doctors give high quality, cost efficient care. Counties with the right proportion of primary care to specialty care have populations who live longer and health care that costs less. Too many specialists and not enough family physicians leads to unnecessarily expensive care and shorter life expectancy. I believe that family doctors provide something intangible to our ...

Read more...

I had a pretty grueling office session yesterday -- one of those days where you're sending someone to the hospital and calling another consultant on the phone and bouncing among three rooms at once.  A typical family medicine day. I was 45 minutes late seeing my last patient.  I was a little surprised that she was still on the schedule -- we had actually resolved her issue over the phone the ...

Read more...

When I was a fourth-year medical student in 2002, I signed up for an intense sub-internship rotation in family medicine.  My goals for this rotation were two-fold: first, I wanted to make sure that I was ready for intern year and, second, I needed a good letter of recommendation to match into a good family medicine residency program. On this rotation, I was essentially treated like the other interns.  I had ...

Read more...

How I weather the yearly residency cycle I've been a family medicine residency faculty member for nearly 5 years, and I've come to observe the yearly cycle of a residency over that time.  Reminding myself of that cycle helps me weather and celebrate the peculiarities of each time of year. July-September: Adjustment Every resident's role changes on July 1.  For the first-years, it's their first day of being called "doctor."  Second- and third-year ...

Read more...

This question was what drove me to graduate school for an MPH degree a few years ago.  I was finishing up my family medicine residency at, arguably, one of the top residency programs in the nation.  I had been well trained in both medical science and doctor-patient relationship skills.  Yet my patients still consistently did not adhere to my advice. I was not disappointed in my MPH studies.  It turns out ...

Read more...

Let's explore one of the most well-studied health behavior theories - the health belief model (HBM). The HBM states that our health choices are a direct consequence of our perceived susceptibility to a disease, our perceived severity of a disease, and the perceived barriers that keep us from adopting better habits. Perceived susceptibility, perceived severity, and perceived barriers are three of the main constructs from the HBM.  The word "perceived" is very ...

Read more...

I inherited motion sickness from my father's side of the family.  I can't sit in the back seat of a car for more than 10 minutes without becoming sick.  I take meclizine before every plane flight. I inherited asthma from my mother's side of the family.  Exposure to perfume, 90+ degree temps with 90+% humidity, or even a good laugh will all prompt me to cough. These two maladies of mine have ...

Read more...

We need to change the definition of beauty Wrinkles are bad. So are small breasts. Also crow's feet and age spots. Jiggly arms and muffin tops. Don't forget untrimmed pubic hair. This tirade isn't limited to women. Guys, are your muscles ripped? Chest gleamingly hair-free? Male member sufficiently enhanced? On a regular basis, I see 9 to 11 year-old girls who tell me that they're cutting back on what they eat because they're "fat." While I'm examining them, ...

Read more...

Please dont wear perfume to the doctors office Along with about 8.4% of the US population, I have asthma. To promote good doctor-patient communication, I can't sit too far away from you.  To perform a high-quality physical examination, I must enter into your personal space.  Several minutes of inhaling that strong scent, however, can cause me to have trouble breathing. I've never been brave enough to bring this up before, ...

Read more...

Narcotic pain medication prescribing is an issue heavily laden with emotion these days. I have observed that most doctors tend to fall on one side of a spectrum bordered by these two extremes: "Undertreated pain is worse than addiction." On one end is the doctor who is deeply, morally troubled by patients in pain. This doctor is not unaware of the risk of addiction but is willing to risk being taken advantage ...

Read more...

2 Pages