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“The physician–patient encounter is health care’s choke point” -NEJM

A Country Doctor Writes

Its basic argument was that it isn’t sustainable to only see patients one by one in traditional doctor visits. I thought of it the other day when I put together a presentation about Galileo’s way of interacting with patients. Most medical practices are still stuck doing piecework.

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Oregon-based medical group Northwest Permanente announces affiliation with The Permanente Medical Group of Northern California

Permanente Medicine

Affiliation will allow groups to drive high-value care and innovation PORTLAND, ORE, April 16, 2025 – Oregon-based Northwest Permanente (NWP) and The Permanente Medical Group (TPMG) of Northern California announced a formal affiliation today. TPMG comprises nearly 10,000 physicians in 116 specialties, providing care for 4.6

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Episode 148: Antiracism in Medicine Series Episode 4 – Dismantling Race-Based Medicine Part 2: Clinical Perspectives

The Clinical Problem Solvers

Our guests explain how we can incorporate race-conscious medicine in clinical settings, medical education, and biomedical/epidemiological research to responsibly recognize and address the harms of racial inequality. Where can you give an extra inch to those for whom you are caring?

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J-Tip for infant Lumbar Puncture? Does needle free anesthetic help?

PEMBlog

Some general recommendations to reduce pain during LP include: Comfortable Positioning: The patient should be instructed to lie on their side with their knees drawn up to their chest and their chin tucked in, or sit upright with their head and upper back forward (often on a bedside table with a pillow). for the lidocaine group and 4.8 (0.5)

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Updates in ID and Nephrology: Lona Mody, Rasheeda Hall, Devika Nair, Sonali Advani

GeriPal

When I’m on service these days there is inevitably a moment when a resident says “Patient so-and-so is on X” – and I have absolutely no idea what X is. Alex: And we are delighted to welcome Rasheeda Hall, who is a physician scientist in the division of nephrology at Duke University School of Medicine, and sees patients at the Durham VA.

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Gabapentinoids – Gabapentin and Pregabalin: Tasce Bongiovanni, Donovan Maust and Nisha Iyer

GeriPal

The FDA-approved indications for gabapentin are only for treating patients with partial seizures or postherpetic neuralgia. valproic acid and gabapentin), in nursing homes, particularly patients with Alzheimer’s disease and related dementias. There are a lot of reasons that may explain the massive increase in use of these drugs.

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Dialysis vs Conservative Management for Older Adults: Manju Kurella Tamura, Susan Wong, & Maria Montez-Rath

GeriPal

If the purpose of initiating dialysis is improving function – our complex, frail, older patients are likely to be disappointed. And the main topic of today is a paper in Annals of Internal Medicine , Maria first author, that addressed the tradeoffs between initiating dialysis vs continued medical/supportive management.