Last week's New England Journal of Medicine features an important article by Dr. Thomas Bodenheimer, Primary Care -- Will it Survive?  I encourage all of you to read it. Dr. Bodenheimer starkly presents the looming crisis in primary care.  Patients are waiting increasingly long for shorter appointments, freq...

Quitting smoking is probably the hardest thing I ask my patients to do.  Many patients try to quit multiple times before finally being able to quit permanently.  Smoking is a frustrating and profound addiction. A new medication has recently been approved for smoking cessation.  The medication is varenicline and is being marketed under the brand name More

Last Saturday's business section of the Los Angeles Times featured an article by James Gilden that discusses the benefits of concierge medicine for frequent travelers.  It tells the very dramatic story of one of my patients, Mr. Andrew Gitkin, who found...

Chronic venous insufficiency is a very common and very uncomfortable condition. It occurs when the valves in the veins of the legs become leaky, leading to leg swelling, pain and itching. When severe, skin breakdown can occur. The most effective treatment is compression stockings, which can be uncomfortable and difficult to use. An effective oral medication would be a major advance in terms of con...

An important study in this week's New England Journal of Medicine expands what we know about the benefits of cholesterol lowering medications. Statins, a family of cholesterol lowering medications which include Crestor (rosuvastatin), Lescol (fluvastatin), Lipitor (atorvastatin), Mevacor (lovastatin), Pra...

Some of my patients ask me if I "believe in" Eastern, or holistic, or homeopathic medication. The truth is I don't "believe in" any kind of medicine. I need to be convinced. I'm not a Western medicine chauvinist; I'm an evidence-based medicine chauvinist. If there is a good study that supports that a medication is safe and effective I'll use it. I won't ask if it comes from the East or West, or ...

Many of my patients are frequent business travelers. Travel presents its own set of health challenges, from the risk of prolonged immobility in small airline seats, to the risk of acquiring respiratory infections on a plane. One painful consequence of travel that we've all experienced is jet lag. Especially when crossing several time zones, jet lag can make the first day or two at your destination...

An interesting study in the July 6 issue of The New England Journal of Medicine confirms what many physicians and patients have suspected: experience leads to quality. The study looked at over 20,000 patients with respiratory failure (inadequate or stopped breathing) in 37 different hospitals. The patients...

(Thanks to my patient J.R. for pointing me to this story.) A little over a month ago a Seattle TV station broadcast a news story about inflammatory breast cancer. You can read the story or watch the video on the station's website. Since then, interested viewers have emailed the story to friends and acquaintances and the video has been viewe...

I wrote in March about the controversies regarding prostate cancer screening, and I made the point that, unfortunately, it is still not clear whether or not diagnosing prostate cancer early saves lives. This week's Los Angeles Times Health Section features More