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To refer—or not?
My mentor often told me that a competent family physician should be able to manage about 80% of patients’ office visits without consultation.
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3 steps we can take to address childhood adversity
The research strongly supports a causal relationship between adverse childhood experiences and a host of mental and physical ailments.
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A (former) skeptic’s view of bariatric surgery
My skepticism, however, has changed to cautious optimism for carefully selected patients.
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4 pearls for treating musculoskeletal pain
Studies remind us to harness the placebo effect, rather than dismiss it.
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A bright—not bleak—future for family medicine
I remain bullish on family medicine and believe the future remains bright for those who practice high-quality primary care.
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When our biases derail the diagnosis
My partner saw the patient's myxedematous face and knew she had hypothyroidism—not hyperlipidemia.
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When the correct Dx is elusive
Reevaluate your asthma patients to be sure they have the correct Dx, and keep Parkinson's in the differential for patients with atypical symptoms...
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We need to treat gun violence like an epidemic
Imagine it—a day when violence goes the way of polio.
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Reduce unnecessary imaging by refining clinical exam skills
A thorough physical exam and selective plain x-rays are all that is needed for initial evaluation of most knee injuries.
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Point-of-care ultrasound: Deploying in primary care
Hopefully point-of-care ultrasound will become a standard part of family medicine training and practice sooner, rather than later.
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Time for another cup of coffee … or two
At least I can feel better about the 4 cups of coffee I drink every day!
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Let’s get physical!
Walking was as good as PT and exercise classes in one back pain study.
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Is obesity a disease?
Remember that a 5% to 10% weight loss is beneficial—especially for patients with diabetes.
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Skip the antidepressant when the patient has chronic disease?
One can only speculate as to why this antidepressant was not effective in this population.
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Getting it right at the end of life
Now, most dying hospitalized patients are cared for by hospitalists who may be meeting the patient for the first time.