- More and More Pills for 25-30% Better Odds of This, That and The Other – Some Patients Want That, and Some Will Run the Other Way
- Let Patients Lead – Explaining Addiction and Recovery to Families
- We Have Lost Track of the Natural History of Disease
- Patients Are the Real Healers
- Sickle Cell Disease and Phenylketonuria (PKU): You May Have the Genes, But Your Diet Determines Your Symptoms
- Ordering Tests Without Using Words: Are ICD-10 and CPT Codes Bringing Precision or Dumbing Us Down?
- A Country Doctor Reads: September 20, 2019 – Full Circle With Sertraline, Airmanship and Mastery in Medicine, EMR Notes Exaggerate Comprehensiveness
- Despair and Happiness in America and in Medicine
- A Country Doctor Reads: September 14, 2019 – Life Forms Inside Us are Controlling Our Behavior
- I Have a Strong Relationship with my Bank but I Almost Never Go There. How Could this Translate to Primary Care?
- A Country Doctor Reads: September 7, 2019 – Workarounds in Healthcare, Empathy in he Age of the EMR, US vs Swedish Postoperative Pain Management
- When Was the Last Time You Saved Somebody’s Life?
- Magnesium Deficiency: An Undiagnosed Epidemic Behind the Epidemics of Heart Disease and Diabetes
- A Country Doctor Reads: August 31, 2019 – Polypill for CVD risk reduction; Assisted living is a money-making fantasy; Why doctors should read business journals
- Vertigo is a Symptom, Not a Diagnosis, and it’s Sometimes Caused by Loose Rocks Inside Your Head
- Cultivating Charisma in the Clinical Encounter (and emulating Marcus Welby, M.D.)
- A Country Doctor Reads: August 17, 2019
- Whom Does the EMR Serve? Who Owns and Who Needs THE STORY?
- Passed a Stress Test With Flying Colors and Had a Heart Attack on the Way Home, How Could That Happen?
- A Country Doctor Reads: August 10, 2019 – High Blood Pressure is High Blood Pressure, No Matter Where or When
- A Day of Practicing Medicine Without the Computer
- A Country Doctor Reads: July 28, 2019
- How Much Should Physicians Touch?
- “Thanks for Your Time”: Einstein’s Relativity in the Clinical Encounter
- A Country Doctor Reads: July 21, 2019 – Big Data
- Everybody Seems to be an Expert, Except Your Family Doctor?
- A Patient in the Lobby Refuses to Leave: Medical Emergency, Unhappy Customer or Active Shooter?
- A Country Doctor Reads: July 12, 2019
- The Stages of a Man’s Life
- A Country Doctor Reads: July 6, 2019
- Medicare PSA Screening Reversal: Yesterday’s Quality Measure is Today’s Rejected Claim
- I Wish My Clinical Hunches Were Wrong More Often
- My New Life
- Psychiatrist: My Medicine Raised Our Patient’s Blood Sugar, Can You Help? PCP: That’s a Dump!
- Our Profession is Deprived of its Language
- A Country Doctor Reads: June 1, 2019
- Is Hate Ever Therapeutic?
- Beyond the Other Viagra: Curiosities in Off-Label Prescribing
- A Country Doctor Reads: May 19, 2019
- The Folly of Self Referral
- A Country Doctor Reads: May 11, 2019
- Brief is Good
- A Country Doctor Reads: May 4, 2019
- Today’s Doctors: Colleagues or Free Agents?
- The ABCs of Beginning a Clinical Encounter
- A Country Doctor Reads: April 27, 2019
- An Upcoming Anniversary
- Drug Rehab, Life Hab (ilitation)
- A Country Doctor Reads: April 20, 2019
- If You Are a Doctor, Act Like One
- I Am Not an InstaDoc*; This Is Not InstaMedicine*
- A Country Doctor Reads: April 13, 2019
- Treatment of Peritendinitis Crepitans: Heparin or Prednisone?
- A Country Doctor Reads: March 30, 2019
- PDSA for Dummies
- A Wonder Drug of Ill Repute
- A Country Doctor Reads: March 23, 2019
- The Power of Focus
- No Information Exchange, Major Diagnostic Delay
- A Country Doctor Reads: March 16, 2019
- An Accidental Cure
- The Cruelty of Managed Medicare
- A Country Doctor Reads: March 9, 2019
- A Science of Uncertainty and an Art of Probability
- A Country Doctor Reads: March 2, 2019
- Almost All We Do is Treat Symptoms
- A Country Doctor Reads: February 23, 2019
- A New Word for Discharge Summaries?
- “Let Food Be Thy Medicine and Medicine Be Thy Food”
- A Country Doctor Reads: February 16, 2019
- Medicine is Not Like Math
- Paralyzed by Insurance Drug Formularies? Don’t Forget Cash!
- A Country Doctor Reads: February 9, 2019
- The Dangers of Practicing Medicine Without Context
- The Man with Brown Fingernails
- A Country Doctor Reads: February 2, 2019
- Checking Boxes
- Unavailable Antidotes
- A Country Doctor Reads: January 26, 2019
- A Spot-On Analogy
- Outlook and EMRs: Culture Clash in the Medical Office
- A Country Doctor Reads: January 19, 2019
- Inhaler Cures GERD?(!)
- The Perfect Office Note? SOAP, APSO or aSOAP?
- A Country Doctor Reads: January 13, 2019
- How I Will Work Smarter in 2019
- Stop Trying to Hijack Medical Huddles! Haven’t You Heard of Constant Contact?
- Blogging While Driving
- There Are Few Shortcuts to Health
- Physicians are Influencers
- Curiosity, Antidote to Burnout
- Touching the Mezuzah – Revisited
- The Root Cause of Physician Burnout: Neither Professionals nor Skilled Workers
- Don’t Do Chronic Care in December
- I Love Calling Patients – And I Don’t
- Ask the Professor
- Sometimes You Just Gotta Treat It
- Reruns
- HELP ME!
- Distance, an American Health Disparity
- The Elfins Return
- Medicalization and Demedicalization in US Healthcare
- Will Technology Keep Us From Thinking?
- A Country Doctor Reads is Moving
- Teflon Doctors and Velcro Patients
- Suboxone for Pain? Not in Maine
- Flirting With Functional Medicine
- How Often Should Doctors Check Labwork?
- What is a Dose of Psychotherapy?
- Where is Relationship, Authority and Trust in Healthcare Today?
- Helping Patients Accept Their “Imperfections”
- Transdiagnostic Treatment Approaches in Primary Care
- When the Patient Can’t Tell You
- You Are What You Eat – Revisited
- Be the Doctor Each Patient Needs
- Fundamentals of Medicine: Diagnosis and Guidance (Not Just Treatment)
- Dear [CEO]: The Letter I Gave My Boss This Week
- M3DICINE: A Word With 3 Meanings
- Endocarditis or Not? A Saturday Triage Decision
- Two Cases of Bubbly Urine
- Only Pain and Fear Bring Patients to the Doctor
- Instant Relief
- Lists of Three: Unforgettable Lessons from Medical School
- If Not a Doctor, Then What?
- A Rare Form of Deafness or a Trivial Case of Congestion?
- Medicare Knows Everything About My Patients, But Hopes I Will Forget
- Guidelines: When Satan Reads the Bible
- Be the Guide, Not the Hero
- Comprehensiveness is Killing Primary Care
- Myopic Versus Hyperopic Views on Physicians’ Work
- The Art of the Message
- Too Many Chest Pains
- The Art of Covering
- Demonic Dreams and Irreversible Psychosis from Commonly Prescribed Big Gun Medications
- What is Healthcare and Who Deserves it?
- My Triple Aim of Medication Assisted Treatment for Opioid Addicted Patients
- Doctors and CEOs Need Time to Think
- Saturday Clinic
- Self-Driving Cars are Like Most EMRs
- Getting it Right
- Primary Care Needs a New Business Model
- My Neurology Professor’s Migraines
- Facial Recognition in My Own Practice?
- The Case For Professional, Not Just Personal, Resilience
- Bread and Butter Medicine
- Upselling in Medicine: Would You Like a Pap Smear with that Ankle Brace, Ma’am?
- Progress in Weekly Increments
- On a Personal Note
- Brilinta or Clopidogrel, Maximum Benefit or Social Responsibility?
- From EMR to Paper to EMR
- Triage at the Front Desk
- My Suboxone License is Capped at 100 Patients, Should My Opioid License Also Be?
- One More Question
- Doceo, Ergo Sum
- Thou Shalt Do More Physicals
- Hanging Up the Stethoscope
- Pneumonia is a Disease. Is High Cholesterol or Osteoporosis?
- A G.O.M.O.
- Talk, Think, Listen and Type
- How I Will Work Smarter in 2018
- The Other Opioid Epidemic
- Routine Physicals, Routine Labs
- A Christmas Wish
- Reengineering Primary Care (Again)
- A Lousy Diagnostician
- Between Patients: The Myth of Multitasking
- Appendagitis – Not a Typo
- Another Thanksgiving Reflection
- Always Ask
- Wasted Education
- A Blackmail Attempt
- The Codes that Disappeared
- Too Early or Timely Diagnosis
- How to Write Like a Dockter
- Give Specialist Doctors a Break!
- A Boomerang Patient
- Annual Evaluations
- The “Patient Centered” Medical Appointment: You Know the Drill
- Cave: Ignoring the NNT
- A Physician’s Lack of Self Awareness
- A Flex Fuel Man
- Caught Between two Paradigms
- Driving my Mini (iPad)
- An Old, New Diagnosis
- A Dream Job
- Thank Goodness(?) for Technology
- From Group Practice to Herding Cats
- The Dunning-Kruger Effect
- Patients from Away
- A Week with no Lab Coat
- Alarm Fatigue
- Medical Records for Amnesiacs
- A Lesson Learned
- A Moving Target
- Quality Medicine: Showing the Math
- Acts of Kindness
- A Pearl From Medical School
- The Real Reason Behind EPCS?
- Horse Medicine
- EMRs: It’s the Interface, Stupid*
- Where Does it Hurt?
- There but for the Grace
- Everybody is Special
- A Bug in His Ear
- Imagining a Doctor Shortage
- The Power of ACT
- Peer to Peer
- All or Nothing
- Stop Excessive Measurement
- Why Can’t We Speak Our Own Language?
- Remembering the Inpatient Workup: All the Tests to the Patient’s Bedside
- Medicine is a Love that Finds Us
- EMRs Should Be Like Rental Cars
- “Did You Read My Chart?”
- A Day in the Life of Sir William Osler
- Dropping the SOAP Note
- Friday’s Lessons
- Not On Call
- Diagnoses Right Under My Nose
- Doctors Should Be Paid Like Athletes
- Everything Goes Through Me
- The Illusion of “Other People’s Money”
- Don’t Ask Me to Work for the Other Side
- The Meaningful Use Paradox
- An Anniversary of Sorts
- One Shot Medicine: The Stilted Pseudo-comprehensiveness of American Primary Care
- A Thanksgiving Reflection
- Primary Care Has a Dirty Little Secret
- “When I Was Your Age…”
- If 911 Worked Like a Medical Office Phone System
- Today’s Medicine has no Credibility
- Double-Booking the Doctor is Half-Booking the Patient
- Something Extra
- Return visit: A Samurai Physician’s Teachings
- The Art of Asking
- Three Dutchmen Walked Into an Eye Clinic
- Return Visit: Changing the Subject
- Doctoring, In Simple Terms
- Return Visit: A Shot in the Arm
- Opiates, Pain and Integration
- A Motherless Child Without a Father
- A Failed Transition of Care
- “Just in Time” Information – Lessons from Manufacturing
- No Better
- The Intricacies of Antidepressant Interactions
- A Fifteen Minute Man
- EMRs, PCMH and OCD are Limiting Access to Care
- Role Play
- A Country Doctor, Duped
- A Transformative Visit
- Don’t Squeeze, Tie, Slap or Bite the Hand that Feeds You
- A Day of Real Doctoring
- From Learned Professionals to Skilled Workers: The Dangerous De-professionalization of Medicine
- 35 Years of Burnout
- A Really Bad Bruise
- Inside and Out
- An Outsider’s View of Cardiology
- Cave: The Patient Who Suggests a Diagnosis Before Telling You His Symptoms
- Specialists in Diagnostics
- An Invitation
- A Straight Face Test for Health Care: Would Patients Pay for This?
- The Interview
- All I Want For Christmas: Seven Things I Wish My EMR Could Do
- Night Call
- “This is America, You Don’t Have to Do Anything!”
- Not on a Silver Platter
- Art and Archetypes in Medicine
- Husbands and Wives
- The Reinvented Wheel, Now Square
- A Sore Thumb
- It’s Time We Stop Comparing Health Care to Manufacturing
- Absolution
- The Legend of the Avoidable Hospital Readmission
- A Black Hole
- A Very Careful Driver
- “And Stay Away From Doctors”
- Missing the Old A&P
- The Man With the Shrinking Lung
- Humming Jeopardy
- Normal Blood Pressure
- Medical Anamnestics
- Border Doc
- Does Lightning Strike Twice?
- A Near Miss, Technology Notwithstanding
- The Sick Game of Medicare D Formularies
- When a Housecall is Worth a Thousand Tests
- Outdated Equipment
- All the President’s Mail
- The Man with the Up and Down Blood Pressure
- The Art of Antibiotic Selection
- It’s Time We Talk: A Doctor is a Doctor is a Doctor, Right?
- Three Dimensional Doctoring
- Equanimity and the 25% Rule
- It’s Time We Talk: Why Should Doctors Treat the Well and Nurses the Sick? – Part Two
- It’s Time We Talk: Why Should Doctors Treat the Well and Nurses the Sick? – Part One
- Nailing the Diagnosis, Failing the Patient
- Checklist or choke list?
- Requests Denied
- It’s Time We Talk About Who Should Do What in Healthcare Teams
- A Swedish Patient
- It’s Time We Talk About What Healthcare Really Is: Public Versus Personal Health
- And Then, What Happened?
- A Rash of Rashes
- Where is the Mind?
- Cave! Ultracrepidarianism
- Doctors Speaking Accountanese
- Angry Docs
- Suddenly Expensive Generics
- “I Also Tame Wild Horses”
- The Great Imposter
- Less is More, More or Less
- Calling Mrs. Kafka
- Is it the Devil or God in the Detail?
- Neither Doctor nor Priest
- A Country Doctor in his Sixties
- Context, Always
- Med School, Day One (1974)
- Medicine is Easy, but Metamedicine is Hard
- Primary Care is Personal and Passionate
- Primary Care is not General Motors
- Primary Care is Messy
- Incentive, Bribe or Kickback?
- Primary Care isn’t Brain Surgery
- Exit Diagnosis
- The Art of Diagnosis
- Recapturing Abundance
- Be Prepared
- The Ghosts in the Exam Room – Part 2
- The Ghosts in the Exam Room – Part 1
- The Red Blues
- What’s in America’s Medicine Cabinets?
- Free Blood Pressure Check
- Treating Symptoms
- A Tight Squeeze
- How Should Doctors Get Paid? – Part 5
- How Should Doctors Get Paid? – Part 4
- How Should Doctors Get Paid? – Part 3
- A Fire In the Belly
- “I Hate Coming Here”
- Let Doctors be Doctors
- The Illusion of Electronic Prescribing
- An Act to Eliminate Constipation
- How Should Doctors Get Paid? – Part 2
- Never Assume – Indeed!
- How Should Doctors Get Paid? – Part 1
- Never Assume
- Bedside Manner and the Pendulum Effect
- Aequanimitas – Doctors Stirred, not Shaken
- Monocular Vision in Horses and Physicians
- Epicrisis
- The Art of Being Sick
- Wrestling the Rooster
- From Scribbles to Scribes: Newspeak and Foma in the Medical Record
- Good, Strong Heart Beat – 140 and Regular
- Children Who Never Grew
- One Visit, One Problem?
- Signed, Harvey Cushing
- Pain and Suffering
- Twenty Questions
- When the Doctor is the Treatment
- Doctors Without Heroes
- A Country Doctor Acquitted
- Hippocrates’ First Aphorism
- “I am here, Doctor”
- Low Tech Medicine
- Albert Schweitzer, Action Hero
- Practicing Medicine Requires a Patient Relationship
- “Aaah, it’s Good to be Back!”
- Saturday’s Child: A Country Doctor Reads Hillman and Chopra
- What is Osteoporosis?
- “Examine Thoroughly, Explain Simply”
- Morbus Propedeuticus
- Avoiding Retirement
- The Night Before Surgery
- Fifty-Fifty Propositions
- What a Country Doctor Should Write
- Quality or Conformity Revisited
- What if Physicians Worked for Free?
- A Samurai Physician’s Teachings
- Doctoring in the Here and Now
- Absolute Risk
- Controlling Physician Behavior: From Socialized Medicine to Social Marketing
- Sharing Territory
- A Country Doctor’s Unlived Life
- A Minute of My Time
- The Art of Prognosis
- Touching the Mezuzah
- The Secret Of Life
- A Country Doctor Watches Marcus Welby, M.D.
- Blood – The Doctor Giveth and the Doctor Taketh: Myths, Beliefs and Evidence
- Rural Medicine – Not Just Runny Noses
- Journey’s End
- QS, Ad Lib and PRN
- Art, Science and Charity in Medicine
- The Art of the Referral Letter
- When To Take Medication
- Negative Expectations
- Cell Phones Welcome
- A Doctor By Any Other Name?
- Life and Death
- A Country Doctor Practices Telemedicine
- The Art of Listening: Narrative, Hermeneutics and the Electronic Medical Record
- The Gift of Healing: Pastor Graf and Henri Nouwen
- Jumping to Conclusions
- Today’s Masterpiece
- “I’m Sorry Mrs. Jones, But You Have Albuminurophobia”
- How to Clicker Train Your Doc
- Morbus Iatrogenicus
- Squandered Jing
- A Part-Time Healer
- Never Mind
- A Christmas Message to All Physicians from Sir William Osler
- A Far Too Typical Visit
- An Amended Diagnosis
- Off Course
- The Gift of One Day
- The Virtues of Oligopharmacy
- Whom Does the Medical Record Serve?
- In Manu Medici: The Art of Administering and Prescribing Medications
- Following the Path of the Soul
- Patient Centered or Evidence Based Medicine – Can we really have both?
- A Cleansing
- Lifetime Nutritional Balance
- A Drug Launch Lunch
- “I Know Your Type”; Doppelgänger and Archetypes in Everyday Medicine
- Dear Patient,
- The Counterintuitive Concept of Burnout Skills
- A Memorial Day Memento
- An Angry Diabetic
- Calling It Quits
- A Snowbird’s Return
- A Reluctant Interventionist
- A Sore Spot
- The Art of Scheduling: Air Traffic Control in the Medical Office
- Intuiting Alexithymia
- Clinical Instinct
- A Letter from the Board of Medicine
- An Embarrassing Allergy
- Regrets
- Useless Medicine
- A Judgment Call
- The Dance (2011)
- “Why Am I So Dizzy?”
- An Incomplete Workup
- Two Red Herrings
- A Red Herring
- “I Need A Doctor When I’m Sick!”
- “Will You Be My Doctor?”
- The Art of Measuring Blood Pressure: Pseudohypertension, Oscillations and the Silent Gap
- A Deadly Interaction
- Welcome Stranger
- Changing the Subject
- Night Flight
- B.C.
- Holiday Cheers
- Brand Name Drugs and Generic Prescribers
- Guy Talk
- Signing Off
- “Mommy, I’m Going to Die!”
- No Refill
- The Oldest Disease
- One Track Minds
- Amy Laughs With The Angels
- All is Well; Over and Out
- Finding the Way
- The Long Journey
- The Call
- Fearing the Worst
- Playing the Odds
- Mechanical Voices
- Fecal Occult Blood Tests Illustrate What’s Wrong With Health Care Today
- Dinner With A Homeopath
- Bitter Medicine
- Doing Nothing
- A Walking Time Bomb
- “Cure Sometimes, Treat Often, Comfort Always”
- Shooting From The Hip
- The Minimum Effective Dose
- “Would You Take Me Back?”
- “You Give Me Hope”
- Too Good to be True
- Why Not to be an Early Adopter
- “Dog Ain’t Right”
- Happy Birthday, Country Doctor
- Meals on Wheels
- “Treating to Target”
- “That Doctor Is A Nurse!”
- Continuity of Care
- A Bad Case of Congestion
- “Needs Prior Auth”
- The Last Supper
- Feeling Like A Doctor
- The 15-Minute Hour
- Beyond the Male Menopause
- One-Liners
- Abnormal Chemistries
- Switching Places
- The Emperor’s New Bones
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- Time, Money and Midlevels
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- Invisible Ties
- A Work Excuse
- Decision Support, Professionalism and the Lost Art of Healing
- Off The Record
- What Are We Doing?
- Problem List Problems
- A Negative Stress Test
- “You Don’t Know Me!”
- A Cancelled Appointment
- A Terminal Case
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- The Jig Is Up
- Snap Diagnosis
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- Face-to-Face
- “Choices, Gentlemen”
- Scrubs, Ties and Stethoscopes
- Attitude!
- A Posthumous Blessing
- The Art of the Intramuscular Injection
- Quality or Conformity?
- Saying No
- Thanksgiving Potpourri
- See You Next Time
- Starting Over
- Who Needs a Physical?
- A Hero’s Pain
- A Real Pain
- The Shadow of the Object
- If You Find It, You Own It
- Trouble at 6 O’clock
- The Power of Words
- “Thank You, Father”
- A Thirty Year Anniversary, And I Missed It
- Basic Knowledge
- Who Wants To Know?
- Dear Doctor D,
- An Empty Stall
- Yesterday’s Children
- A Tale of Two Sisters
- My Most Expensive Instrument
- Thicker Than Water
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- One Strike, You’re Out!
- Proof of Chickenpox
- Oh, By the Way, Doc
- The Apostolic Nature of Our Profession
- A Shot in the Arm
- My Annual Checkup
- A Physician’s Funeral
- Clinical Pneumonia or Virtual Health?
- A Negative Workup
- Instant Feedback
- Our Last Visit
- All My Children
- An Easy Keeper
- Local Firefighter Gives Doctor Thanksgiving Pie
- Loss of Power
- When I’m Sixty-Five
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- A Change of Heart
- A Nice, Clean Doublewide
- A Train Wreck* With Two Car Wrecks
- The Concept of Risk
- All God’s Children
- No More Headaches!
- A Day Without a Diagnosis
- The Good Mother
- “Doctor, What Would You Do?”
- An Innocent Looking Rash
- Twinkle’s Back!
- It’s Only Pressure
- You Are What You Eat
- Happy Hour
- One Last Signature
- Left Behind (In the Dust)
- Playing Doctor
- My Father’s Eyes – The Photographs
- Visions of Little People
- A Concurring Second Opinion
- The Dreaded Visit with Priscilla Pye
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- A Little Man
- Another Young Man
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- Friday’s Child
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- Time’s Up!
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Recent posts
- More and More Pills for 25-30% Better Odds of This, That and The Other – Some Patients Want That, and Some Will Run the Other Way
- Let Patients Lead – Explaining Addiction and Recovery to Families
- We Have Lost Track of the Natural History of Disease
- Patients Are the Real Healers
- Sickle Cell Disease and Phenylketonuria (PKU): You May Have the Genes, But Your Diet Determines Your Symptoms
- Ordering Tests Without Using Words: Are ICD-10 and CPT Codes Bringing Precision or Dumbing Us Down?
- A Country Doctor Reads: September 20, 2019 – Full Circle With Sertraline, Airmanship and Mastery in Medicine, EMR Notes Exaggerate Comprehensiveness
- Despair and Happiness in America and in Medicine
- A Country Doctor Reads: September 14, 2019 – Life Forms Inside Us are Controlling Our Behavior
- I Have a Strong Relationship with my Bank but I Almost Never Go There. How Could this Translate to Primary Care?
- A Country Doctor Reads: September 7, 2019 – Workarounds in Healthcare, Empathy in he Age of the EMR, US vs Swedish Postoperative Pain Management
- When Was the Last Time You Saved Somebody’s Life?
- Magnesium Deficiency: An Undiagnosed Epidemic Behind the Epidemics of Heart Disease and Diabetes
- A Country Doctor Reads: August 31, 2019 – Polypill for CVD risk reduction; Assisted living is a money-making fantasy; Why doctors should read business journals
- Vertigo is a Symptom, Not a Diagnosis, and it’s Sometimes Caused by Loose Rocks Inside Your Head
- Cultivating Charisma in the Clinical Encounter (and emulating Marcus Welby, M.D.)
- A Country Doctor Reads: August 17, 2019
- Whom Does the EMR Serve? Who Owns and Who Needs THE STORY?
- Passed a Stress Test With Flying Colors and Had a Heart Attack on the Way Home, How Could That Happen?
- A Country Doctor Reads: August 10, 2019 – High Blood Pressure is High Blood Pressure, No Matter Where or When
A Country Doctor Reads:
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