A New Therapy for Asthma

I first met Carol* (name and identifying details have been changed) when she came to my clinic after a severe asthma attack had sent her to the Intensive Care Unit.  After a few days, she had been extubated and had acquired a new diagnosis, asthma.  When she saw me in clinic, she felt better than … Continue reading

What I Learned at the ATP Reunion Conference February 2014

I. Capitation is coming Although Brent was careful to stress that despite this being gospel among those who “have drunk the kool-aid” it is not universally accepted. Still, the alternative narrative is just more of the same – more efficient fee for service – or aspirations for competing as one of a handful of fee-for-service … Continue reading

The State Fair

“I got run over by a golf cart at the State Fair,” my five-year-old cheerfully says to the Emergency Department technician who is checking us in. A utility cart knocked him down – he is a five-year-old running along the grass by the path, and some asshole wasn’t looking as he turned into my kid … Continue reading

Pre-existing Condition

“I didn’t have the sleep study that you recommended,” he says.  I wait.  “I went for the consultation.  She said that looking at me (30 year young fit man), I don’t fit the stereotype for sleep apnea, but talking to me, she thinks I have it and I should have the study.” I tell him … Continue reading

Gorilla Glue and Heartbreak

“My friend said to tell you everything when I come,” she says as she opens a little zippered bag full of flakes. “My teeth are falling out and I can’t afford a dentist, so I use Gorilla Glue to glue back the pieces,” she says. She was referred to me for severe asthma, but she … Continue reading

Slow Medicine

Time heals all wounds, they say, or, in medicine, if not all, then many.  But with our improved efficiency and throughput of patients, we fail to allow this most magical treatment to work.  The pace and intensity of medicine has increased exponentially over the past several decades.  We see more doctors, have more procedures, take … Continue reading

What I Learned at the ATP Reunion Conference Feb 2012

Hi all, happy valentine’s day!  I hope you’re all doing well.  It was fun to meet up with some of our class for the reunion conference.  While this conference was not the life-altering event our class was, I still found it useful and thought I’d share some of the things I learned at the conference. … Continue reading