I have a patient in my practice, Francisco, who showed up to the walk-in clinic one day looking awful. His wife had driven him— insisted, he told me. Fransisco was an always-upbeat guy who I had treated over the years for the major and chronic (uncontrolled diabetes) to the minor and self-limited (smashed thumb). He’s... Continue Reading →
If you are a person with a lot of choices, with a job that offers health insurance, with a social security number and a safe place to sleep and knowledge of where your next meal is coming from, I can see how you might think a market-based healthcare model is a good idea. You might... Continue Reading →
It sucks to be sick. Full stop. A UTI sucks. Pneumonia sucks. Cancer sucks. People who have chronic illnesses, though, have an additional set of challenges to face. Some of these challenges are summed up in the idea of self-management, which is complex in and of itself. The definition of self-management that I like comes... Continue Reading →
In medicine, "lifestyle measures" is code for diet (DASH, or myplate) and exercise (20 minutes/day!) — not for sleep, for relationships, for stress management, meditation, personal growth. . . Can these things be taught in 15-minute office visits? How can we move away from the sound-bite advice and into meaningful change?
I saw a patient recently who came in for knee pain. Fairly typically, he was a fifty-ish, smiling, slightly chubby guy who thought he was pretty healthy, felt ok, and never went to the doctor. As I like to do with people like this, I evaluated his knee pain and then suggested we look at... Continue Reading →
This stuff is the truest truth I know, but it’s hard to impart it 20 minutes at a time to people who want you to fix what’s wrong with them. My clinic is full of people-- good, hardworking, courageous people who want to be healthy, and who have diabetes, high cholesterol, high blood pressure, or... Continue Reading →