In a recent Forbes editorial, conservative commentator John Goodman argues that the Texas Medical Board is sending the state back to “the middle ages” because they are trying to limit the practice of medicine in the absence of a face-to-face, doctor-patient relationship. He believes that telemedicine should have an unfettered role in health care -- diagnosis and treatment should be available to anyone who wishes to share their ...

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shutterstock_189396983 Out-of-context quote of the day: “We have no malls and no Walmart.  Recruitment is nearly impossible.” These astonishing statements were made by Elizabeth Nelson, a nurse practitioner in Nebraska.  She was not talking about teenage summer jobs.  She was not talking about professional Walmart greeters, addicts of cheap stuff made in China who want an employee discount, or people who really like Cinnabon.   ...

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shutterstock_246706588 Did you know that you are a “telemedicine provider”? No? I can’t blame you for not knowing, but you are, and always have been. Well, maybe not always, but certainly since Alexander Graham Bell invented the telephone. Better yet, you provide free telemedicine services. Here is an idea: on the home page of your practice website, you should add a big ...

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When I began the practice of medicine, I used to think of the entranceway to the exam room in mystical terms.  How else could I explain my patient's willingness to suspend all social rules and norms upon passing through those magical doors?  They would sit down in front of their baby faced-doctor and talk about things.  Private things.  Scary things. Conversations occurred that would be unthinkable if two strangers were to ...

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shutterstock_163737929 "I want to tell you my story now," a patient recently told me, a woman who suffers from many physical and emotional ailments.  She had the diagnosis of PTSD on her problem list, along with hospitalizations for "stress," but I never asked beyond that. "OK," I answered, not knowing what to expect.  "Tell me your story." She paused for about 30 seconds, but I ...

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Who can argue against evidence-based medicine? Who can argue with using evidence to develop guidelines? The key to practicing great medicine must involve using the best evidence to guide our protocols. My son, while in college, was an English major. I remember reading his papers. He often used the phrase “on further reflection.” I often recall that phrase when considering these complex issues. Frederick Nietzsche wrote, “There are not data, only interpretations.” ...

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shutterstock_134876816 You’ve probably heard that we remember negative things we’re told ten times longer than positive things. What’s the implication for those of us in the medical field? Does all that negativity create more burned out doctors? If you’re at all like me, those negative things started in your training. Did you feel tortured during grand rounds or oral board exams? Yeah. Me, too. And ...

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shutterstock_155822504 Readers know that I am a conservative practitioner.   I rail against overdiagnosis and overtreatment.  Less medicine results in more healing and protection.  In an example, I have explained previously why I advise patients not to undergo total body scans, despite the lure that they offer a cancerophobic public. I’ve never undergone a CXR in my life.   I’ve never entered medicine’s tunnel of ...

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My oldest son is almost a second grader. He attends a public elementary school in town, and very soon, he will start preparing for an exam known as the STAAR test. The STAAR test is an “assessment of academic readiness.” In my state, it gets administered to publicly-funded school children. Students must pass the exam to continue progressing in school, and ultimately, students must master the exit level test to graduate high school. There’s good ...

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shutterstock_138885635 I am presenting my startup costs here, to give some ideas for those providers who are considering starting their own family practice, or for those who say it can’t be done anymore. To become a business, I spent $50 for the state LLC filing, and $12 for business cards. I already had my medical license and DEA from residency, so the only certificate ...

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