The health benefits of exercise are well-established. A recent study published in the Journal of the American College of Cardiology showed that one’s fitness level, as measured a person’s one mile run speed, compared to other cardiovascular risk factors, was the best single predictor of heart attack risk and life span. Studies have shown that regular exercise reduces one’s risk of obesity, diabetes, and hypertension. Exercise has been ...
Juliet K. Mavromatis, MD
When specialists try to practice primary care
Recently a good friend asked me to recommend an excellent primary care physician in New York City. When no one immediately came to mind, I asked a couple of doctor-friends who trained in New York. One friend, a cardiologist, gave me two names—one was a rheumatologist, who also practices general medicine, and the other an infectious disease doctor by training. My initial reaction to my cardiologist friend’s suggestion that ...
What patients need to know about finding and treating osteoporosis
Osteoporosis is a condition that is sure to become increasingly diagnosed as our population ages.Osteoporosis is significant because it is associated with an increased risk of bone fracture, including fracture of the hip and vertebra, which are the cause of significant morbidity, mortality, loss of independence and medical expense in the elderly. In current clinical practice, osteoporosis is diagnosed on the basis ...
Lack of sexual interest is the most common sexual complaint in women
Lack of sexual interest is the most common sexual complaint in women.The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), which defines psychiatric disorders, defines Hypoactive Sexual Desire Disorder (HSDD) as ‘‘persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity’’ that causes ‘‘marked distress or interpersonal difficulty.’’ Epidemiologic surveys have suggested that from 25 to 50 percent of women report prolonged periods ...
Lessons learned from asthma therapy
As a kid I had allergies and asthma.Because of this, for several years, my mother wrote a note excusing me from the 600 meter run in elementary school. My father took me to weekly allergy shots. At times I had eczema on my forearms and eyes, and according to my allergist, whose notes I later read, I had moderate allergic shiners (also known as dark circles under my eyes). My ...
Questions about the early diagnosis of Alzheimer’s disease
Alzheimer's disease made headlines recently, first with news about a new biomarker test that is able to diagnose the disease with increased accuracy, then with a follow-up story detailing the collaborative model of data-sharing that contributed to the success of recent research.As I read the news with interest I couldn't help but feel that in our current climate, the manner in which it was reported was ...
How you can avoid skin cancer risk
Skin cancer is the most common form of cancer diagnosed in the United States.There are three major types: basal cell, squamous cell and melanoma. Of those, basal cell and squamous cell are most common, accounting for about 3.5 million cases in the United States per year. Although, these types typically do not metastasize, they can be quite disfiguring, particularly after resection when they occur on the face. On a population ...
PCMH and retainer fee medicine are primary care solutions
For years now we’ve been hearing about the trials and tribulations that have evolved in the practice of primary care medicine.However, the discussion has intensified in recent months with passage of national health reform. Recent publications highlight the problems. A paper in the New England Journal of Medicine by Dr. Richard Baron entitled, What Keeps Us So Busy in Primary Care? discusses the time spent by primary care ...
How doctors can discuss advance directives with patients
A recent blog post and series of responses on KevinMD.com aroused my interest.Dr. Kevin Pho posed the question: Why are doctors so reluctant to discuss end-of-life care? Responders, including patients, doctors, nurses, and even a veterinarian highlighted the stress inherent in this discussion for patients and for medical professionals alike.To me, the real issue is not whether the discussion should occur, because clearly it should, but when and how? ...
Twitter and Facebook can affect the doctor-patient relationship
“I would be careful,” a fellow physician cautioned, as I told of my plans to attend a patient’s birthday party.In my 12 years of clinical practice I have lived in the community in which I practice, less than two miles from my office. I encounter patients daily in the supermarket, at soccer games, swim meets and school events. I have had conversations with patients at parties, on the street, and ...
How primary care should manage chronic pain patients
In April 2010 the American Society of Anesthesiologists (ASA) published updated guidelines for the management of chronic pain. The guidelines were based on a review of recent scientific evidence as well as a survey of expert opinion. As I read through the guidelines, summarizing the efficacy of various therapies for chronic pain ranging from epidural injection to medication management, some of my most challenging clinical cases involving pain management ...
