ACDW: Blog Archive 2008 - present
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Archive
Practicing at the Top of Your License is Not an Option for Primary Care Physicians
Ask Not What Your Next #EMR Can Do for You, Ask What You Won’t Have to Do for It
The Unreasonable Burden of Specialty Level Diagnostic Specificity in Primary Care
The Future of Doctoring is Already Here: Do More, Give Less Or Burn Out
A Milestone in Child Mortality: Guns Kill More Kids Than Motor Vehicles Do
The Broken Promise of Computers in Healthcare: A Doctor From the B.C. Era Explains
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)
Your Doctor Remembers Most Things About Medicine, But Not Everything About You
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)
Don’t Be Insulted If I Prescribe Narcan Along With Your Pain Medication
Dosing Warfarin: From Flowsheet to Workflow. Is This Progress?
The Useless, Almost Drive-Through, Nearly Touchless, Free But Expensive and Wasteful Physical Exam
Don’t Eat More of Anything (Until You Decide What to Eat Less Of)
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
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 Country Doctor Practices Bibliotherapy: Books by Prescription
I Heard About Chilblains in British Television Shows, Not in Medical School
Care Reminders? No Time to Think on the Clinic Assembly Line
Broken Relationships and Sudden Social Isolation are Like Opiate Withdrawal (BOTSA via NYT)
This Time, it’s Different: The Man Who Cried Wolf and the Doctor Who Listened
My Patient Has Hepatitis C. He Tested Positive Five Years Ago And Nobody Told Him
A Country Doctor Reads: New Swedish Psychiatry Celebrities on Incels and Narcissists
Medicine is a Moving Missile, Aiming for a Dangerous, Elusive Target
A Country Doctor Reads: THOUGHTS OF A TEENAGER (and a Blast From the Past)
Anxiety, Worry or Fear? Disappointment, Grief or Depression?
I Just Diagnosed a Case of SOD, Although I Admit I Wasn’t Quite Familiar With It
A Woman With Classic Angina and Two Test Abnormalities: Artifacts, Really??
Health Insurance is a Stumbling Block in Many Patients’ Thinking
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
Set It and Forget It: My Successful First Use of Ambulatory Blood Pressure Monitoring
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
Fatigue, Tinnitus, Dizziness and Dyspnea. What’s the Diagnosis?
Can the Practice of Primary Care Medicine ever be Practical Again?
There is a Word for People Like Me: AMBIVERT (A Personal Reflection)
My Blog is Setting Many Records, Except One, a Surprise Hit from 2015
NNT: The Number Needed to Treat in Order to Prevent One Bad Event
Doctor-Patient Relationships: I Don’t Babysit – I Want to Empower
Did Covid and Telemedicine Finally Make the Physical Exam Obsolete?
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
New Book: SAMPLES – Recent Writings on the Art of Medicine. $2.99 on Amazon
Morgellons? I Made the Diagnosis of DP. Now I Have to Figure Out How to Manage it.
Cholesterol Guidelines and the Bachelor With Platform Shoes – 13 Years Later
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
Doxepin, a Little Known Super Drug in My Personal Black Bag of Tricks
The Art of Clinical Decision Making: Friday Afternoon Dilemmas
A Double Hit of Imperfect Technology and Massive Centralization
Driverless Cars or Keyboardless EMRs? Which Do We Need Most?
“I Don’t Cook” is an American Epidemic (But A Country Doctor Cooks)
The S-Word (Social) Suddenly Has a Place In American Medicine
There Are Three Kinds of Primary Care, Not to Be Confused With Each Other
The General Public is Meant to be Deceived: The American Food Conspiracy
Quality in Healthcare: Cultural Competence, Diagnostic Accuracy or Patronizing Insensitivity?
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
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
Swedish Analysis: Dark Triad Personality and Denying the Dangers of Covid-19
Where’s Waldo: Finding What’s Important in the Medical Record – KevinMD
“It’s the Interface, Stupid” Revisited: If X-Box Can, Why Can’t our EMRs?
Local TV Story on First Book in “A Country Doctor Writes” Series
More Profit in Treating Chronic than Acute Diseases – Today’s Post on KevinMD.
Aren’t We All Somewhere On the Spectrum of Disease? – The Deductible
Oats: Junk Food or Health Food? Ingredients are Only the Beginning
When a diagnosis leads to sadness instead of triumph – 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
The New Normal is Still Unknown, on Earth as it is in Healthcare – The Health Care Blog
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
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
Black Box Warnings: Time to Reconsider Our Disease=Drug Reflex?
As Physicians Today, We Must Both Represent the “System” and Disregard it
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”
Asinine, Backasswards Colonoscopy Insurance Rules Make Patients Decline Medically Necessary Testing
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
The Public Health To-Do List is Choking Doctors and Jeopardizing Patients’ Lives
The Liability of Outside Provider Orders and What Could be Done About It
Changing EMR – Seamless Continuation, Dreaded Chore or Fresh Start?
Let Patients Lead – Explaining Addiction and Recovery to Families
Ordering Tests Without Using Words: Are ICD-10 and CPT Codes Bringing Precision or Dumbing Us Down?
A Country Doctor Reads: September 14, 2019 – Life Forms Inside Us are Controlling Our Behavior
Magnesium Deficiency: An Undiagnosed Epidemic Behind the Epidemics of Heart Disease and Diabetes
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.)
“Thanks for Your Time”: Einstein’s Relativity in the Clinical Encounter
A Patient in the Lobby Refuses to Leave: Medical Emergency, Unhappy Customer or Active Shooter?
Medicare PSA Screening Reversal: Yesterday’s Quality Measure is Today’s Rejected Claim
Psychiatrist: My Medicine Raised Our Patient’s Blood Sugar, Can You Help? PCP: That’s a Dump!
Beyond the Other Viagra: Curiosities in Off-Label Prescribing
Treatment of Peritendinitis Crepitans: Heparin or Prednisone?
Stop Trying to Hijack Medical Huddles! Haven’t You Heard of Constant Contact?
The Root Cause of Physician Burnout: Neither Professionals nor Skilled Workers
Where is Relationship, Authority and Trust in Healthcare Today?
Fundamentals of Medicine: Diagnosis and Guidance (Not Just Treatment)
Medicare Knows Everything About My Patients, But Hopes I Will Forget
Demonic Dreams and Irreversible Psychosis from Commonly Prescribed Big Gun Medications
My Triple Aim of Medication Assisted Treatment for Opioid Addicted Patients
Upselling in Medicine: Would You Like a Pap Smear with that Ankle Brace, Ma’am?
Brilinta or Clopidogrel, Maximum Benefit or Social Responsibility?
My Suboxone License is Capped at 100 Patients, Should My Opioid License Also Be?
Pneumonia is a Disease. Is High Cholesterol or Osteoporosis?
The “Patient Centered” Medical Appointment: You Know the Drill
Remembering the Inpatient Workup: All the Tests to the Patient’s Bedside
One Shot Medicine: The Stilted Pseudo-comprehensiveness of American Primary Care
From Learned Professionals to Skilled Workers: The Dangerous De-professionalization of Medicine
Cave: The Patient Who Suggests a Diagnosis Before Telling You His Symptoms
A Straight Face Test for Health Care: Would Patients Pay for This?
All I Want For Christmas: Seven Things I Wish My EMR Could Do
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
It’s Time We Talk About Who Should Do What in Healthcare Teams
It’s Time We Talk About What Healthcare Really Is: Public Versus Personal Health
From Scribbles to Scribes: Newspeak and Foma in the Medical Record
Controlling Physician Behavior: From Socialized Medicine to Social Marketing
Blood – The Doctor Giveth and the Doctor Taketh: Myths, Beliefs and Evidence
The Art of Listening: Narrative, Hermeneutics and the Electronic Medical Record
A Christmas Message to All Physicians from Sir William Osler
In Manu Medici: The Art of Administering and Prescribing Medications
Patient Centered or Evidence Based Medicine – Can we really have both?
“I Know Your Type”; Doppelgänger and Archetypes in Everyday Medicine
The Art of Scheduling: Air Traffic Control in the Medical Office
The Art of Measuring Blood Pressure: Pseudohypertension, Oscillations and the Silent Gap
Fecal Occult Blood Tests Illustrate What’s Wrong With Health Care Today
Decision Support, Professionalism and the Lost Art of Healing