ACDW: Blog Archive 2008 - present

Instant access to almost 1,000 posts by Yours Truly, in reverse chronological order - 4 cents a piece...

Archive

• Practicing at the Top of Your License is Not an Option for Primary Care Physicians

• A Blast from the Past in My Blog Stats:

• Bucksport Recovery Community

• I Love Explaining Medical Things

• Ask Not What Your Next #EMR Can Do for You, Ask What You Won’t Have to Do for It

• All Body Parts are Not Created Equal

• Old Habits Die Hard in Medicine

• A Country Doctor Writes is Now Also on Substack

• What Healthcare Needs Today is Professional Grandmothers to Offload Burned-Out Doctors by Delivering Common Sense Advice that Medical Assistants aren’t Allowed to Give.

• Dear Patient, If You Have to Treat a Cold, Know This:

• The Unreasonable Burden of Specialty Level Diagnostic Specificity in Primary Care

• Record Breaker!

• The Future of Doctoring is Already Here: Do More, Give Less Or Burn Out

• An Unusual Case of Meralgia Paresthetica

• Previsit Planning: What, Why and For Whom?

• Most Read Posts in 2021 (if not ever…)

• Happy New Year!

• Medicine, Like Survival and Living Well, is an Art

• A Country Doctor’s Christmas

• Doctor Playing Vet

• A Milestone in Child Mortality: Guns Kill More Kids Than Motor Vehicles Do

• Seizures: Low P, Low D and Lots of THC

• Doctors Working for Free

• Be Thankful for Ordinary Days

• My First Case of Restless Chest Syndrome?

• More Pictures From the Life of a Country Doctor

• The Dangers of EMR-Defaulted Prescription Stop Dates

• The Broken Promise of Computers in Healthcare: A Doctor From the B.C. Era Explains

• A Country Doctor’s Life

• How Much Time Should Doctors Spend With Their Patients?

• From Warrior to Wise Man: Former Coast Guard Reflecting on the Healthcare Workplace

• A Country Doctor Reads: What if Burnout Is Less About Work and More About Isolation? (NYT)

• My Fibromyalgia Patient With Chronic Back Pain and Gout Swears That Colchicine is a Miracle For All Three of Her Painful Conditions

• Award Day

• Acceptance Speech (long version): 2022 Carol Eckert, MD Memorial Award, Maine Primary Care Association

• Awarded by the Maine Primary Care Association:

• Delivering Health Care is Like Practicing a Religion

• Make it So

• Your Doctor Remembers Most Things About Medicine, But Not Everything About You

• Five Plain Truths About Gout

• I Do Fewer Elective Procedures Now Than When I Started Out. This is Why:

• A Renaissance For Phrenology? (A Country Doctor Reads 8/24/22)

• Replay: A DOCTOR’S PARTING WORDS

• Don’t Be Insulted If I Prescribe Narcan Along With Your Pain Medication

• The Intrusive, Insensitive Nature of Primary Care

• 7687

• Understanding a CBC (Complete Blood Count)

• Abnormal Lab Tests: Not Always a Sign of Disease

• Dosing Warfarin: From Flowsheet to Workflow. Is This Progress?

• A Country Doctor Reads: Consider the Vagus Nerve, No Matter What Seems to be the Diagnosis | The Wall Street Journal

• A Country Doctor Reads: The Solution Shop and the Production Line — The Case for a Frameshift for Physician Practices | NEJM

• Changing EMR Again: Goodbye Greenway, Hello Epic

• The Useless, Almost Drive-Through, Nearly Touchless, Free But Expensive and Wasteful Physical Exam

• Somebody Stole My Inhaler Idea. Finally!

• There Are Too Many Back Seat Drivers in Medicine Today

• Quick and Easy: How to Save Primary Care

• All These Gut Feelings: A 10-Year Old With Belly Pain

• Don’t Eat More of Anything (Until You Decide What to Eat Less Of)

• Why Can You Have Angina With Normal Coronary Arteries? For the Same Reason You Can Have Heart Failure With Preserved Ejection Fraction

• Another Gut Feeling: A Case of Visceral Hyperalgesia?

• Big Leg, Little Leg: The Lymphedema That Came and Went (Comments invited)

• Health Care Through the Back Door: The Dangers of Nurse Visits

• Since When? Looking for Change: The Heart of the Art of Diagnosis

• A Very Near Miss: The Worst Bout of Sciatica Ever

• Notes From My Sick Bed: Cold War, Viruses and History Repeating Itself

• How to Talk to Clinicians: Forget Workflows, Just Tell Us How Things Work

• Hijacked for Public Health Purposes: Previsit Planning and Morning Huddles

• A Stubborn Rash: When Doctors Don’t Communicate

• A Country Doctor Practices Bibliotherapy: Books by Prescription

• Always Looking for Zebras

• The App That Helps Me Be a More Patient Centered Physician

• The Misunderstood Medicinal Use of Yogurt

• I Heard About Chilblains in British Television Shows, Not in Medical School

• Care Reminders? No Time to Think on the Clinic Assembly Line

• A Year of Extremes: From Medieval Masks to mRNA Vaccines; From Science Denying Flat Earthers to the Prospect of Civil War

• I Hate to Encourage Pharmacy Shopping, But I Have to

• Another Christmas Message

• Why I Tell My Patients They Can Take Their Levothyroxine With All Their Other Medications, Even With Food

• Broken Relationships and Sudden Social Isolation are Like Opiate Withdrawal (BOTSA via NYT)

• What the Pandemic Taught Us About Public Health

• Why is the Patient Here?

• The Healing Power of Even Virtual Human Connection

• There is Comfort in a Name

• This Time, it’s Different: The Man Who Cried Wolf and the Doctor Who Listened

• Is This Really a Time to Give Thanks?

• Dumbing Down Doctors: A Profession Without a Language

• Old Information

• A Kind Review of My Books in FAMILY MEDICINE

• Behind the Mask

• My Patient Has Hepatitis C. He Tested Positive Five Years Ago And Nobody Told Him

• A Wasted Peer-to-Peer Call for my WellCare Patient

• Confusing Numbers in Medicine

• “I Just Want an X-ray”

• A Back Door to Treatment

• N 95 Mask As Screening For COPD?

• “Has a Bad Cold, Please Call”

• An Anxious Man With Coronary Plaque

• Don’t Take an Aspirin and Call Me in the Morning

• Dear Uncle Marcus (Welby):

• We Use Too Many Medications: Be Very Afraid of Interactions

• How to be an Expert: Narrow Niche or Novel Juxtaposition

• A Country Doctor Reads: New Swedish Psychiatry Celebrities on Incels and Narcissists

• Medicine is a Moving Missile, Aiming for a Dangerous, Elusive Target

• A Gut Feeling: Could This Case Really Be That Simple?

• We Shouldn’t Tolerate Sloppy Allergy Lists

• American Primary Care is a Big Waste of Time (When…)

• Still Smiling At “A Moving Target”

• I Am a Decision Maker, Not a Bookkeeper

• A Country Doctor Reads: THOUGHTS OF A TEENAGER (and a Blast From the Past)

• Swedish Telemedicine Psychiatric Prescribing

• A Man With Sudden Onset of Gastroparesis

• Labor and Delivery

• Anxiety, Worry or Fear? Disappointment, Grief or Depression?

• Friday Afternoon: Elevated D-dimer. Ho, Hum

• Cold Feet

• Progress Note: August 31, 2021

• We Are Living in the Dark Ages, and Night May Soon Fall

• Burnout? Not Even Close!

• Wading Through Unsorted Requests: I Don’t Care If You Call Them “Tasks” Or “Jellybeans”, It’s the Stupidest Thing About EMRs

• Speaking of Bile: We Should Consider It More Often

• Revitalizing the U.S. Primary Care Infrastructure | NEJM

• I Just Diagnosed a Case of SOD, Although I Admit I Wasn’t Quite Familiar With It

• “That New Medicine You Prescribed…”

• A Woman With Classic Angina and Two Test Abnormalities: Artifacts, Really??

• Whose Medical Necessity Is it Anyway?

• Add a Medication, Don’t Switch (Yet)!

• Health Insurance is a Stumbling Block in Many Patients’ Thinking

• Self Care During the Pandemic

• A Country Doctor and the Ancient Wisdom of a Samurai Physician

• Medical Imaging is Less Revealing and More Subjective Than Patients Think

• In a Perfect World, Ancient Drugs Would Not Cost More and More Over Time

• “Patient Requests 90 Day Supply”

• The Lazy Man’s Guide to Calorie Counting

• The Middle Age Creep

• A Country Doctor Writes eBook Price Drop

• EHRs Are Workarounds, Rerouting the Way Physicians Work

• Getting to the Doctor When You’re Sick and Scared

• “I Thought I’d Wait Until My Appointment”

• Anxiety? It’s All in Your Head. Your Sinuses, to Be Exact

• Practicing Where the Action Is

• When Dogs Lick Their Wounds

• The Power of Silence (Reflections on Writing)

• An Easy Choice

• The Case of the Stop and Go Pills

• Set It and Forget It: My Successful First Use of Ambulatory Blood Pressure Monitoring

• Patient: “Another Doctor Said Keto Was Bad For Diabetics” – Me: “Let Me Tell You the Story of the Flex Fuel Man”

• Funny Examples of Swedish Medical Terminology

• “Fruit is God’s Candy”

• The Art of Diagnosis: Go With Your Gut, Dig Deeper, Step Back or Start Over

• When I Escalated His GERD Treatment, My Patient Got Worse. Now I Know Why

• “This Doesn’t Usually Hurt that Much”: Patients With Fibromyalgia Spectrum Disorder

• Another Birthday Reflection

• Fatigue, Tinnitus, Dizziness and Dyspnea. What’s the Diagnosis?

• Can the Practice of Primary Care Medicine ever be Practical Again?

• I Actually Love Technology

• Habits for Health and Happiness

• The Gift of Time

• The Art and Soul of Medicine Exist in the Ordinary

• The Science of Clinical Intuition

• To Understand What You Already Know

• There is a Word for People Like Me: AMBIVERT (A Personal Reflection)

• The Call to Be a Primary Care Doctor

• The Annual Physical: Is it Worth Having?

• My Blog is Setting Many Records, Except One, a Surprise Hit from 2015

• Does Tramadol Create More Cold Blooded Killers?

• The Complete Workup: Virtue or Waste?

• Another Quick Listen

• TSH, T3 and T4: The Conductor and the Orchestra

• A Lesson Learned is a Lesson Remembered

• “Nothing Acute”

• The Perils of Being First

• NNT: The Number Needed to Treat in Order to Prevent One Bad Event

• HYPERTENSION is Like Driving a 5-Speed in 4th Gear

• Doctor-Patient Relationships: I Don’t Babysit – I Want to Empower

• BANANAS: Potassium, Calories and Constipation

• Hey, Doc, What Do I take For a Cold? Nothing!

• Peak Flow Meter, Tuning Fork and Blank Pieces of Paper: Things I Would Rather Not Practice Without (Besides My iPhone)

• Allergies and Hives

• Why I Seldom Recommend Vitamins or Supplements

• Did Covid and Telemedicine Finally Make the Physical Exam Obsolete?

• A Short Video For Patients Based on My Warfarin Post:

• Three Challenges in the Art of Prescribing Warfarin

• Serving is No Longer a Useful Term, Especially For Snack “Foods”

• Working Too Hard Doesn’t Cause Burnout. Having to Do the Wrong Thing Does

• Revisiting the Advantages of aSOAP Notes: The Best of the Paper Chart and Old School Photography

• Voicemail, Repeat Requests and Multitasking: Inefficiencies in Today’s Healthcare

• The Art of Medicine is Not an Algorithm

• Food is a Hot Potato

• New Book: SAMPLES – Recent Writings on the Art of Medicine. $2.99 on Amazon

• Suboxone Saves, Builds and Rebuilds Lives

• Morgellons? I Made the Diagnosis of DP. Now I Have to Figure Out How to Manage it.

• “Tell Me More”

• What Does Your Patient Need to Hear You Say Right Now?

• Five Weight Loss Myths I am Constantly Fighting

• Cholesterol Guidelines and the Bachelor With Platform Shoes – 13 Years Later

• Screening for Depression: Then What?

• Some People Don’t Think Like Doctors (!)

• My Latest Post on A Country Doctor Talks:

• New Symptoms With Old Explanations

• Why I Don’t Order Fasting Bloodwork Anymore

• My First VLOG: A Country Doctor Talks

• THESE WERE NOT COMPUTER BOTS: My Patient Said he Had Bugs Crawling Under his Skin

• Please Sign Below: Fraudsters Phishing for Physician Signatures

• The Parallel Realities of Health Care: Ratio and Intellectus

• Other Super Drugs in My Personal Black Bag of Tricks

• THE PAIN IS IN YOUR BRAIN: Your Knees Know Next to Nothing

• Doxepin, a Little Known Super Drug in My Personal Black Bag of Tricks

• The Art of Clinical Decision Making: Friday Afternoon Dilemmas

• Find me on Facebook

• The Art of the Chart: Documenting the Timeline

• An Uncommon Cause of Shortness of Breath

• A Double Hit of Imperfect Technology and Massive Centralization

• The Art of Diagnosis: Teasing Out the Timeline

• Canada’s Buttergate: Invasion by a Trojan Cow

• “I Don’t Do Windows” Says the Maid. “I Don’t Do Machines” Says this Doctor – “But I Do Nudge Therapy”

• The Art of Listening: When the Inner Voice Whispers

• How I Write

• It Pays to Play Dumb Sometimes

• The Art of Asking: What Else is Going on?

• Driverless Cars or Keyboardless EMRs? Which Do We Need Most?

• Playing Poker With the Devil: “Prior Authorizations” are Paralyzing Patients and Burning out Providers

• “I Don’t Cook” is an American Epidemic (But A Country Doctor Cooks)

• The S-Word (Social) Suddenly Has a Place In American Medicine

• Why We Need Good Primary Care Physicians

• The Art of Asking: What’s Your Biggest Fear?

• The Art of Prescribing (Or Not)

• The Art of Explaining: Starting With the Big Idea

• There Are Three Kinds of Primary Care, Not to Be Confused With Each Other

• The Art of Asking: Show Me Where it Hurts

• This is Not Health Care

• The Art of Triage: What’s the Worst Thing This Could Be?

• The General Public is Meant to be Deceived: The American Food Conspiracy

• The Art of Tinkering: The Man With Cold Fingers

• Quality in Healthcare: Cultural Competence, Diagnostic Accuracy or Patronizing Insensitivity?

• A Country Doctor’s New Year’s Resolution

• I Can’t Stop Blogging

• Stop Bashing Nurse Practitioners: The Dunning-Kruger Effect is Everywhere

• A Christmas Message to All Physicians From a Swedish-American Country Doctor in Maine

• The Year When Everything Changed: Covid, Self Care and High Tech Innovation In Medicine

• Featured Again in Sweden’s Journal of General Medicine

• The Art of Listening: A Not-So-Simple UTI

• The Art of Listening: Cause and Effect

• The Art of Listening: Beyond the Chief Complaint

• Stewardship: We Worry More About the Environment than Our Own Bodies

• CRAZY AMERICA: Health Insurance Covers Testing When You Are Well But Not When You Are Sick

• PATIENTS: Sufferers, Consumers or Something In Between?

• I Still Love Being a Doctor – KevinMD

• Swedish Analysis: Dark Triad Personality and Denying the Dangers of Covid-19

• Courts Interpret Laws Differently – Even the Supreme Court, Depending on Individual Justices. Compare that with Interpreting Medical Science!

• Physicians’ Communication Skills are Overlooked and Undervalued – Today’s Exclusive on The Health Care Blog

• Where’s Waldo: Finding What’s Important in the Medical Record – KevinMD

• How we Deliver Medication Information – a Reblog on KevinMD

• “It’s the Interface, Stupid” Revisited: If X-Box Can, Why Can’t our EMRs?

• My Latest on KevinMD – 7/26/20 on ACDW

• A Country Doctor Writes: IN PRACTICE : Starting, Growing and Staying in the Medical Profession – eBook and Paperback

• If We Can’t Have a Universal Electronic Health Record, We at Least Need a Single, Universal, Medication List Plug-In

• Local TV Story on First Book in “A Country Doctor Writes” Series

• Book Update: Labor Day Release Will Have New Title

• CONDITIONS Paperback Bulk Orders

• More Profit in Treating Chronic than Acute Diseases – Today’s Post on KevinMD.

• One of My Burnout Posts on Today’s KevinMD

• Post Covid Healthcare is Becoming Like Buying from Amazon Instead of Going to the Mall or Reading an eBook Instead of a Paperback – My Latest Post on The Health Care Blog

• Driving With James Taylor

• Take the Poll: Should I Narrate My Book for Audible?

• A Country Doctor is in Australia – Medical Observer

• I Cured My Patient, But What Was His Diagnosis?

• Aren’t We All Somewhere On the Spectrum of Disease? – The Deductible

• A Country Doctor Writes: CONDITIONS – Now Also in Paperback

• Oats: Junk Food or Health Food? Ingredients are Only the Beginning

• July 4 Book Release Update

• When a diagnosis leads to sadness instead of triumph – KevinMD

• A Country Doctor Talks – KevinMD

• Participating in the greatest miracle a physician is privileged to be part of – KevinMD

• There’s a code for pain, but what’s the code for suffering? – KevinMD

• First Book Available for Pre-Order

• Will Telemedicine Make Us Better Diagnosticians? – KevinMD

• The New Normal is Still Unknown, on Earth as it is in Healthcare – The Health Care Blog

• Post Scriptum

• A Dozen Years of Writing About Doctoring

• Meaningful U’s

• A Country Doctor Reads: Why Walking Matters – The Wall Street Journal

• My Patients with Anxiety and PTSD are Handling Covid-19 Better than Most

• Will the Covid-Induced Telemedicine Scramble Change Primary Care Forever?

• Covid-19 is Bringing Out the Worst Dishonesty in Some Patients

• A Country Doctor Reads: Why Sweden isn’t Restricting Personal Freedom During the Covid-19 Pandemic – Svenska Dagbladet

• Why Do Patients Trust their Doctor? Because He or She is a Competent Mensch

• A Country Doctor Reads: How South Korea Flattened the Curve – The New York Times

• A Country Doctor Reads: Job Crafting for Character – Harvard Business Review

• American Telemedicine Has Gone Viral

• Depression in Modern Times: We Have Many Friends and Followers, But Low Perceived Social Support Scores Can Make Us Sick

• Black Box Warnings: Time to Reconsider Our Disease=Drug Reflex?

• Hope is a Contagious Force of Healing

• As Physicians Today, We Must Both Represent the “System” and Disregard it

• American Primary Care and My Soviet Era Class Trip: Sensing the Inevitable Collapse of a Top Down Bureaucracy

• The Science of Placebo and Nocebo Effects Puts the Doctor-Patient Relationship on Par With the Effectiveness of the Pharmaceuticals We Prescribe

• Medicine is Child’s Play: Where’s Waldo, Spot the Difference and Whack-a-Mole

• “The Four Horsemen of the Medical Apocalypse”: It’s All About Inflammation

• Atherosclerosis and Nonstick Frying Pans: Newfangled Medications or Time Tested Lifestyle?

• My Favorite Visit: “25 Minutes with More than 50% Spent on Counseling and Education”

• Medical Records in Primary Care: Keeping the Story of Phone Calls and Medication Changes with Less than Perfect Tools

• Asinine, Backasswards Colonoscopy Insurance Rules Make Patients Decline Medically Necessary Testing

• Ad Usum Proprium: Physician, Treat Thyself!

• “I Want Complete Labs Ordered Before My Physical”

• Doctoring in 2020: Why is the Patient Here? Whose Visit is it Anyway?

• As a Doctor, I Should be a Keener Observer and Notice the Pathology All Around Me

• Chronic Disease Drugs are Big Business, Antibiotics are Not

• Tell Me Again Why We Should Screen for Early Alzheimer’s?

• Doctoring at Christmas

• The Public Health To-Do List is Choking Doctors and Jeopardizing Patients’ Lives

• Thou Shalt Not Try to Outsmart Me

• The Liability of Outside Provider Orders and What Could be Done About It

• The Polyvagal Theory: The Science Behind Therapeutic Relationships, Stress Related Illness and Long Term Effects of Trauma

• Changing EMR – Seamless Continuation, Dreaded Chore or Fresh Start?

• Ten Building Blocks of Therapeutic Relationships

• Screen Sharing With Patients

• If Nothing Else Works, Try a Horse

• Clinical Depth: The Power of Knowing More than the Minimum

• Revisiting the Concept of Burnout Skills

• Leveraging Time by Doing Less in Each Chronic Care Visit

• 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

• 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

• A Quick Listen

• Time, Money and Midlevels

• “But I Still Have Chest Pain!”

• 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

• Noah’s Journey

• The Jig Is Up

• Snap Diagnosis

• A Bad Case of Nerves

• 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

• An Imaginary Mentor

• 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

• What Do I Call You, Doc?

• 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

• My Father’s Eyes – The Song

• An Anxious Daughter

• My Senior Colleague

• A Little Man

• Another Young Man

• Orthorexia Nervosa – Too Much of a Good Thing

• Altered Vision

• Choices in Swedish Health Care

• Is There a Doctor On Board?

• Friday’s Child

• Doctor Fix-It

• Tuesday Evening House Call

• Shadow Syndromes

• Physicians and Chiropractors – Like Priests and Rabbis

• Catch-up Time

• A Doctor’s Parting Words

• A Doctor’s Advice

• The Doctor’s Doctor

• Clara’s Sinus Headaches

• Physician, Heal Thyself!

• The Correct Diagnosis – Ten Years Later

• Adverse Effects

• Thoughts on My In-Room Cup of Coffee

• Losing a Patient Twice

• A Country Doctor Stops In Brookline

• Sally’s Dilemma

• Caleb Didn’t Limp Yesterday!

• Time’s Up!

• Chocolate – Good or Bad?

• Caleb, Our Horse with a Limp

• My Nurse’s Mother

• A Cobbler’s Mistake

• New Doctors: Too Few, Too Many or Too Late?

• Cholesterol Guidelines and the Bachelor with Platform Shoes