Twice a year from each of the major insurance plans I get a report card showing me how I compare to my peers on prescribing generic medications, formulary medications, and overall cost of medications. For a few years I always felt good about these reports. I consistently look favorable when compared to my peers. I ...
Category Archives: Opinion/Editorial
Is It Possible to Legislate or Regulate Pain Mangement?
First do no harm. Treat every patient with respect and dignity. These are values I try to live by and incorporate into my daily work. Treatment of chronic pain is the scenario that puts me and every practicing primary care physician in a no-win situation regularly in the office. To try to make physicians feel more comfortable ...
I Like Unna Boots
I have to say that I really like Unna boots as therapy for veinous stasis ulcers. I have no idea why they are called Unna boots. If anyone knows, let me know. I couldn’t find anything on-line to explain the name. It’s an ...
Generic Lipitor – Coming Soon
Hang on for real savings. Coming in July 2011 is the expiration of the patent on Lipitor (generic name atorvastatin), the highest gross sales drug in the world. Lipitor, by Pfizer, was still the top gross selling drug in the US despite competition since simvastatin became a generic option. We all were ecstatic when Zocor, ...
Which Excellent Specialist to Choose for Referrals
I’ve been in practice in Puyallup, WA for nearly 25 years. I’m blessed to practice in a medical community where I usually have several options of competent sub-specialists to choose among when I need a consultant to help care for my patients. The first consideration when I choose a physician for my patient is trying ...
Oral Decongestants: Marginally Effective or Ineffective Drugs with Serious Potential Side Effects
I really discourage the use of pseudoephedrine and phenylephrine as a decongestants, especially in adult men. The biggest reason is that they just don’t work very well, and the potential side effects seem to outweigh the benefits. Friday in the office I saw a man in his early 50’s with acute urinary retention. ...
What if All Americans Had at Least Catastrophic Health Care Coverage
I really dislike the term healthcare reform. I think our system needs to be changed not reformed. I assume that I am not the only person who suspects that the recent health care reform act is not going to be the final solution for America’s health care problems. The cost of healthcare is not really ...
Grand Rounds – A Time Gone By
This week at the office I heard one of our physicians inviting our two new medical students to attend "Perinatal Grand Rounds” at a restaurant in Tacoma. My first thought was that some pharmaceutical company had the gall to call one of their sponsored programs “Grand Rounds.” Their programs are usually little more than a ...
Teaching Medical Students
I’m headed off to a reception for students from the new Pacific Northwest University of Health Sciences in Yakima, WA who are spending their third year of osteopathic medical school in Puyallup, WA doing rotations with the physicians in our community. I’ve had a student with me this week, and it brings back memories ...
Tympanocentesis for Treatment of Acute Otitis Media
Sounds pretty radical at first, but maybe we should ask ourselves why acute otitis media is the one easily drainable abscess that we don’t routinely drain, but rather try to treat with antibiotics without drainage. Admittedly acute ear infections often get better with or without ...
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