Category Archives: Opinion/Editorial

Access to Healthcare: The US Income Disparity

In the U.S. our method of rationing healthcare is that if you have good insurance or lots of money you have access to good healthcare otherwise you don’t have access to good healthcare. I believe this is far more reality than the widespread U.S. perception that health care is rationed in countries with government funded universal healthcare.  A… Continue Reading

Why Wait Until 60 for your Shingles Vaccine?

In 2011 Merck received FDA approval to administer Zostavax (Herpes Zoster/ shingles vaccine) in patients age 50-59.  Since 2006 Zostavax has been approved for patients age 60 and older.  So why should you wait until 60 to get shingles vaccine? I wondered this and on reading the ACIP update on Zoster Immunization released this August… Continue Reading

Pros and Cons of Planned Parenthood E-visits for Birth Control Pills

Planned Parenthood has announced that it is launching a program to allow women to obtain hormonal contraception, primarily birth control pills but also contraceptive patches and vaginal hormonal rings via an e-visit online.  This is an attempt to try to reduce the incidence of unplanned and undesired pregnancies that often occur because of women delaying… Continue Reading

Should You Choose a Doctor with Poor Online Ratings?

Maybe so.  Common reasons for poor ratings of physicians online include refusal to prescribe antibiotics for viral illnesses and refusal to prescribe opioid pain medications upon demand.  Physicians are under pressure to “perform” well on patient satisfaction surveys,  to reign in the prescription opioid abuse epidemic and to limit prescribing of antibiotics for self-limited illnesses… Continue Reading

The Price of Success: A Hepatitis C Update

In the United States Hepatitis C recently passed HIV as a cause of death.  The USPSTF has recommended screening all baby boomers for Hepatitis C, i.e. those born between 1945 and 1965, with a category B strength of recommendation. This makes Hepatitis C screening a preventative service that is covered by all insurance policies without… Continue Reading

Reaction to JNC-8 from a Practicing Family Doc

is Practicing physicians rely heavily on certain widely accepted guidelines to set goals and make treatment decisions for our patients.  Among the most respected and followed guidelines are those of the Joint National Committee on recommendations for the diagnosis and treatment of hypertension, often simply referred to as JNC.  The JNC came out with its… Continue Reading

5 Screening and Prevention Measures to Do and 5 to Avoid

Early diagnosis, preventative care and aggressive disease management are mainstays of American medicine today.  Proponents argue that early diagnosis and prevention are the keys to healthy living. Skeptics suspect that many of the screening tests for early assymptomatic disease and preventative treatments we undergo lead to overdiagnosis, unnecessary expense, exposure to diagnostic and therapeutic interventions… Continue Reading

Off-Label Ketamine for Severe Depression

Ketamine is a drug that has been used for decades as an alternative to general anesthesia for some pediatric and other surgeries, and more recently has been used for some types of chronic neurologic pain.  A relatively recent but increasing use is for severe depression that has been refractory to various antidepressants.  There have been… Continue Reading