It had been a long gloomy Fall day. When I got home, all I wanted to do was climb into bed and sleep and sleep and sleep. Emotionally, I was spent after a long day at work. But my husband and I had planned to go to services at temple that night – there was a guest singer that comes once a year, and I love his music. So, with ...

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From the notes I read, it seems that other medical specialties limit “social history” to whether or not someone uses tobacco, drinks alcohol, or uses drugs. “Social history” is meant to get a sense of the context in which people live. Where do they live? Who do they live with? How did they come to live there? Where did they grow up? What sort of work do they do? How much ...

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Doctors are all the same: A sea of uniform “white coats without a face” caring for “patients without a face.” They heal the sick. They save lives. And they drive their fancy sports cars to their expensive homes and cushy lives. Not. I am embarrassed to admit, as a pre-med/medical school hopeful, this was my perception of physicians and patient care before completing two summer internships at a doctor’s office. A problem that the majority ...

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As the national opioid crisis takes center stage, I want to make a case for the authority of the family physician in managing and treating this problem. I am a family physician and have been treating patients with opioid dependence and addiction for 12 years. These patients comprise about half of my practice. The other half is representative of a typical primary care practice. I have patients who have been treated ...

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Too much data, big and small. Every morning when I log onto our electronic health record, one group of messages are from patients with their self-recorded health information data that they've sent to me for review. Here's my home blood pressure over the past 24 hours. Here are my fingerstick glucose readings over the past 24 hours. Here's my weight over the past 24 hours. Here is my depression score over the ...

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If you’re thinking about a career in medicine, there’s a piece of technology you’ll come to know intimately. It’s small and sleek, with excellent battery life and remarkable durability. It’s not an iPhone; it’s not a Pixel. It’s a beeper. You will come to know, and to respect, this tiny black rectangular prism. It will govern your life. You will be at its mercy, yes, but it also offers you a chance at salvation. ...

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I'm now walking the second mile in another man's moccasins, and it's no more enjoyable than my first mile. Many doctors cringe when they see a chronic pain patient on their day's schedule or at least certain chronic pain patients. Some of that dread isn't directly caused by the patient but rather the deluge of third-party administrative demands: workman's compensation updates, disability applications, insurance forms, lawyers' letters, etc. Still, even when the ...

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Greetings from the library. I’m writing to you through caffeine jitters, wrapped in a scarf that doubles as a blanket. I’ve marked my territory with my things: several Apple products, remnants of oatmeal in a mason jar, a sketchbook exhibiting my best attempt drawing the inside of a skull, and the most-essential item: my planner, detailing all the tasks I now avoid. I’m in the midst of my first round of ...

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A study published recently in JAMA Internal Medicine looked at 650,651 Medicare patients hospitalized in 2013. It showed that when patients were cared for by their own outpatient physician, they had a slightly better outcome than when the patients were attended to by full-time hospital-based specialists who had not previously known them. As an internal medicine physician who maintains hospital privileges, as well as caring for patients in ...

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In a very unique study, researchers have tabulated how often family physicians provide patient care that is not covered with a CPT code. This is a little complex, for the non-physicians and even for many physicians to grasp, so I will provide a little more background first. CPT stands for Current Procedural Terminology, which is the book written by the American Medical Association (AMA) since about 1965. This ...

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