Mr. B, the patient who first stirred my interest in family medicine, was a spry former World War Two fighter pilot who came to the ER complaining of an irregular heart beat. I remember him regaling me with stories about the Battle of Britain while his wife dutifully stood by his side in the chaos of the crowded emergency room at a private hospital affiliated with my medical school.
It was …
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There’s a lot of evidence that to prevent many serious health conditions, including diabetes, obesity, heart disease, and stroke, making healthy lifestyle changes are just as good, if not better than, taking medications. Lifestyle changes may consist of stopping unhealthy behaviors such as tobacco and excessive alcohol use, or starting healthy behaviors such as moderate daily exercise and eating adequate amounts of fresh fruits and vegetables.
As anyone who has ever …
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Vitamin D seems to be all the rage in medicine these days. A family physician colleague commented to me recently that the laboratory test for vitamin D deficiency is becoming the most frequently ordered test in his practice.
This clinical bandwagon is likely a response to data from multiple recent studies that found low vitamin D levels in the majority of children and adults of all ages. While vitamin D has …
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You’ve probably had the experience of going to see a primary care physician and wondering about the many aspects of that visit that just didn’t make sense.
Why is it so important for me to arrive on time when, in reality, I won’t be called back until half an hour (or more) later? What’s the point of waiting for another 20 minutes in a chilly examining room for the doctor …
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One of my favorite patients in residency was a lady in her seventies who had longstanding high blood pressure, high cholesterol, and diabetes.
Each time she visited the office, I would recommend that we start multiple medications to control these conditions, and every time she would politely decline. Her previous physicians had left frustrated notes in her chart littered with terms such as “non-compliant,” “against medical advice” and expressing wonderment why …
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Pharmaceutical companies and their shareholders are always looking for the next “blockbuster” drug, the label given to a drug that generates more than $1 billion of revenue per year.
Blockbuster drugs don’t necessarily have to save many (or any) lives – slick marketing more than compensates for marginal improvements in treatment efficacy — but they do need to target conditions that are common enough that millions of patients will buy them. …
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Several years ago, when my wife directed the third-year Family Medicine clinical clerkship at a highly ranked medical school, she developed a popular workshop on the cost of health care that presented students with scenarios of patients who were either uninsured or underinsured and challenged them to provide cost-conscious health care by selecting medications and tests that were clinically appropriate and financially affordable.
Many students remarked that it was the only …
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Not long ago, I attended the Shining Knight Gala, a fundraising dinner that benefited the trauma surgery and injury prevention programs at Virginia Commonwealth University Medical Center.
The highlight of the evening was the dramatic presentation of the story of a young man who had suffered severe, life-threatening injuries in a car accident and, through the skill and dedication of first responders and the VCU trauma and rehabilitation professionals, was stabilized …
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My daughter, who turns two years old in June, is becoming something of a medical rarity. This isn’t because she is showing signs of a late-developing handicap or extraordinary ability for her age – it’s because she came into the world as a vaginal birth after Cesarean section (VBAC), delivered by a certified nurse midwife.
Although more than three-quarters of women who choose a trial of labor over a repeat Cesarean …
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The Framingham Heart Study is perhaps the most famous long-term medical study. As every medical student learns, starting in 1948, the lifestyle habits of thousands of residents of Framingham, Massachusetts were followed to determine important risk factors for cardiovascular disease.
It is because of this study that your physician can, with a few keystrokes, predict with great accuracy your risk of having a heart attack within the next 10 years and …
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The American Cancer Society has designated this weekend “Suits and Sneakers Awareness Weekend,” as part of the annual Coaches vs. Cancer program that will feature well-dressed basketball coaches wearing “sneakers instead of dress shoes with their usual game attire during weekend games to demonstrate their support for the Society and the fight against cancer.” The idea is to encourage people to exercise and eat a healthy diet to reduce their …
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