Submitted by PeterElias on Mon, 03/20/2017 - 06:00
As I watched my 17 month old granddaughter decode the world, it was impossible not to marvel at the enormity of the task and wonder what was going on behind that so expressive face as she processes the flood of sights, sounds, feelings, tastes, experiences, and consequences. Some predictable, but many not.
Submitted by PeterElias on Mon, 03/06/2017 - 06:00
Imagine that you want a boat. You tell someone to build or buy you a boat, and tell them to send you a bill. What would you get? A kayak? A windsurfer? A boat for waterskiing? A sailboat. A party boat? A cruise ship? A submarine? A battleship or destroyer? You probably would not get what you want. Very likely you would end up with something expensive - that you cannot use.
Before you build or buy a boat, you need a defined goal and a process:
Primary care medicine is intense and chaotic, a constantly mutating kaleidoscope of data, emotions, goals and obstacles. It is designed to confuse and distract, and will find and magnify any tendencies towards ADD in even the most organized clinician. During my 30+ years as a family doc, I’ve come to depend on some core principles and concepts to stay grounded and maintain focus. Here are ten core principles I have found useful, with some comments and exposition.
Submitted by PeterElias on Fri, 01/01/2016 - 06:00
You are about to have the honor and great pleasure of working with a group of patients I have come to know and respect over the years. While I cannot tell you how to practice medicine, I feel no reluctance to tell you what made it so worthwhile for me.
Submitted by PeterElias on Wed, 04/22/2015 - 06:00
We have LOTS of guidelines and recommendations. We could use LOTS more humility.
The Advisory Committee for Immunization Practices (ACIP) issued a recommendation in September of 2014 that pneumococcal vaccine naive individuals 65 and over get a Prevnar13 followed by a Pneumovax 6-12 months later, and that those who have had a Pneumovax get a Prevnar13 a minimum of 12 months after their Pneumovax.