November 2, 2021


A new triple threat – 09/22/2021  – Used to the ideal academic provider was a triple threat if he/she conducted original research, taught students and residents, and provided top-notch patient care.  This author argues that this has changed, especially as the writer spends more time juggling work and caring for his three-year-old during COVID.  His definition of the new triple threat which I totally endorse is one who is a well-rounded provider, who is a connected self-care giver, and who is a fully engaged parent!

A Therapeutic Relationship – 11/10/2021  An anecdotal piece focusing on the importance of touching our patients, even during this time of the pandemic.

Code Words – 08/15/2022 -This is a moving perspective essay from a fellow working in the pediatric ER, and is centered around what happens after a young patient dies in the emergency department.

Common Sleep Disorders in Adults: Diagnosis and Management – 04/20/2022  – It’s estimated that 60 million adults report chronically disturbed sleep. Lots of excellent tables, refresh how we counsel about sleep hygiene-no clock watching, no napping during the day, no watching tv or other electronic devices in bed! Go to bed only when sleepy.

Health, Humor, and Harmony – 04/04/2022 – Check this out when you can.  Dr. Roy completed her residency here at Duke.  She lives in NYC and I believe was holding down 3 different jobs all while appearing on MSNBC and NBC news over 300 times during the COVID Pandemic.  She has created a delightful health show that covers a number of themes of interest to primary care providers.

Inherited patients taking opioids for chronic pain- considerations for primary care – 02/22/2022 – Take a look at this article and think about what happens in your clinic when you or a colleague inherit a patient who has been maintained for some time on opioids for chronic pain.  I think the coaching tip is to try to consider providing a therapeutic bridge for the patient until a solid plan of care can be created and agreed upon.

Medical Advice for Commercial Air Travel – 10/21/2021  – This article involves information that would be helpful if you were counseling a patient who might be planning a trip.  Of note, timed melatonin is supposed to be a highly effective way to treat jet lag.

Medication Safety in Breastfeeding – 01/26/2023-LactMed is a good resource that is free and available on line to check safety information for many meds.  SSRI’s are generally safe to use but fluoxetine should be avoided.  Insulin, metformin, and second generation sulfonylureas are preferred over newer agents that are not as well studied.  Note that medications that are safe in pregnancy are not always safe while breastfeeding.

Medical Violence – 11/10/2021 – A compelling article was written by a physician providing care to a diabetic patient with glucose over 500.  The patient was an inmate, and there was moral clarity that the author writes about in a compelling fashion.

Physician-as-Patient-Vulnerabilities and Strengths – 12-27-2022 – Read about some observations from an anesthesiologist who was diagnosed with advanced-stage lung cancer.  She writes about how shame is often associated with this experience, as many wonders if they contributed to the illness by something that was or wasn’t done.  It’s hard for providers to realize that something is not their fault.  Also, the isolation that can occur was addressed.

Nutrition Support Therapy-01/12/2022  -Avoid percutaneous feeding tubes in patients with advanced dementia.

With helpful tables that include guidelines for how best to monitor nutrition support therapy.

Poignant Vignettes –Peak Moments- When Kindergarten is High Risk – A moving perspective article just published, written from the perspective of a mother who has a significant underlying immune abnormality that puts her at high risk for death if she were to become ill with a COVID infection.

Who was she? –  09/23/2022 – This is an important story told by an infectious disease doctor who cared for a 30-year-old pregnant woman with severe Covid pneumonia-the patient had recently migrated from the Caribbean.  The patient was afraid of the potential negative effects of the vaccine on her fetus.  The author writes about how knowing a patient’s country of origin can be important, especially so that we might think about providing culturally congruent resources.