Sometimes, it’s difficult to recall that single defining moment or person that sends you on the path you’re meant to take in life. I was fortunate in that I found that experience halfway through my undergraduate career at the University of California, Davis. I had recently lost my grandmother; although I’d wanted to help, all I’d been able to do at the hospital was translate for her. That overwhelming sense ...

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It makes me crazy when I hear things like, “Doctors are to blame for burnout. They need to just be tougher.” Are people really serious? This is like comparing us to people who are eating super-sized fast food meals daily, while complaining about their jeans being too tight. Not the same. Some will say that burnout is a given and just goes with the territory. Many debate whether this is something that needs to ...

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There’s been a push lately for more explicit labeling of foods -- to make sure that consumers know that what they’re buying is organic, or free-range, or natural, or GMO-free, etc. But these labels don’t tell the whole story. Sometimes, they’re outright lies. For instance, “organic” veggies still contain plenty of pesticides. There are the natural pesticides that ordinarily occur in food, plus the organic-OK chemical pesticides that are ...

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Please turn on your ringer, you might get an important call! From your case worker. Your housing coordinator. From WIC. A question about your SNAP or TANF or immigration papers or medical application. A potential client for your taxi business. Your boss telling you a shift is available. It could be something important. So please answer your phone! All of these callers work from 9 to 5, with a lunch break, so ...

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It is open season on erectile dysfunction. First, a politician in South Carolina introduced a bill to make it hard to get Viagra and then a politician in Kentucky. If the bills pass, they will hold patients with erectile dysfunction hostage to unrelated agendas. You might think that erections would be as politically untouchable as guns. After all, erections are nearly as popular as they are ...

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When I was growing up in the ‘50s and ‘60s, virtually every primary care doctor (pediatrician, internist, GP-there were no FPs) I knew of had his office (women in practice were rare) located in a wing of his home, with the driveway enlarged to accommodate patients.  A new physician in practice would simply hang his name on a shingle in front of the house.  These doctors were paid in cash, ...

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In the last month, I have used the ICD-10 codes Z59.0 (homelessness), Z59.1 (inadequate housing) and Z59.9 (unspecified housing or economic problem) far more than I ever would have imagined. Several patients came into my urban clinic with varied chief complaints, including issues with uncontrolled asthma, chest pain, stress, worsening knee pain and sciatica. However, after listening and asking questions, I quickly realized that all of these initial complaints shared a ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. More than ever before, patients are receiving laboratory test results, with some of their numbers in bold or with “H”s or “L”s next to them. In some cases they’re getting them straight from the lab, in accordance with federal regulations. If not from ...

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It is a common experience to feel that our body has let us down when we get sick. We may feel it is broken or flawed in some way and if only it was better designed we wouldn’t have to suffer illness and disease. Likewise, we tend to consider illness and disease as something bad that has happened to us and which we associate with suffering of some kind, be ...

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Part of a series. I have advocated in this series of posts on direct primary care in one form or another (i.e., membership, retainer-based, concierge and various other incarnations and conceptions) because it works well for both patients and primary care practitioners. Direct primary care allows the doctor the opportunity to give the type of outstanding care that each of us needs, whether currently healthy or beset with multiple ...

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