The evidence is becoming clearer. Plant-based nutrition is best for our health. While I never tell any of my patients to adopt a vegan lifestyle if they don’t want to - it’s hard! - the closer we can get to a plant-based lifestyle, the healthier we will be and the better we will feel. Less cancer, heart disease, arthritis, sleep apnea, and the list goes on.
HERE is a simple way to get started eating healthier.
As the colorectal cancer screening guidelines have changed to start testing at age 45, I'm excited (if one can be about such a thing) to offer free annual colorectal cancer screening (using stool-based FIT testing) to all of my patients. No need to shell out $500 for the heavily-advertised Cologuard or $2k for a colonoscopy. FIT testing is just as good. And now FREE. And everyone poops so there's no reason not to get the test.
A patient of mine recently needed to start checking his blood sugars. If you search online, you find too many options and with wildly varied prices. There are blood sugar meters with bells and whistles, things are wildly overpriced, and how is a patient supposed to know what they’re getting? What will their insurance cover, if anything? $100 for all the supplies is probably standard but is that even a good deal? In a physician job through the healthcare system, I’d write a script and wish the patient luck. Can’t afford it? Go talk to a social worker.
This is where the traditional healthcare system fails patients.
I am lucky to be able to procure these supplies for my patients and pass the savings along to them. This patient agreed to go sans insurance and we got him everything he needs to check his sugars for a whopping $31. The usual blood sugar meter that costs $30 online costs me 2 cents (literally).
Health care doesn’t stop when we say goodbye to our patients after a visit. Doctors need to get out of the old mindset of “goodbye and good luck navigating this mess!”
As an integrative family physician, I like supplements over prescriptions but to be honest, I’m a minimalist for both. Good solid nutrition, regular movement and physical activity, stress mitigation, and quality sleep beat almost everything else against chronic disease.
For those interested in supplements, though, I use LABDOOR and CONSUMERLAB, to vet products.
Two that I’m suggesting patients look into during COVID are zinc 15mg daily and vitamin D3 1000 IU daily. There’s no smoking gun but to prevent COVID or treat mild cases, these are reasonable additions to your daily regimen while you await your vaccine.
Dr. Hagopian wrote a clear, useful update on COVID testing and treatment. You can find it HERE.
While we can’t say we love working weekends, it’s an important part of the DPC gig as healthcare needs don’t always fit in neatly on a Monday-Friday schedule. This weekend, we:
Gave out a handful of free flu shots to our patients
Counseled 2 patients through COVID exposures, made them individualized testing and quarantine plans, and counseled one of their employers on the patient’s exposure
We have made it very clear to our 3-year old son that he needs to wear his helmet whenever he rides his bike or scooter and that this is “a safe choice.”
Well, he’s made it his mission to point out each and every person who isn’t making a safe choice on their bike or motorcycle. Today, he went the extra step and said “That man isn’t making a safe choice. His mommy and daddy are very disappointed…. but they still love him.”
Well said, little man, well said. He’s a family doctor in the making.
“COVID isn’t killing the system. COVID is just exposing the problems that were already there.”
Direct primary care is a great solution for those people who have experienced job loss (and their accompanying health benefits). And it’s also a great solution for people who are staying in jobs they are unhappy in all “because of the benefits.”
Health insurance does not equal health CARE.
There is no time better than now to honor World Mental Health Day. We have a lot going on in our culture to create challenges to mental health so make sure you are looking after yours by getting in some exercise, nature bathing, meditation, or by connecting with friends and family. And as always, if you’re struggling, please reach out to us or a licensed counselor if you’re not sure where to turn. There are lots of people available to help!
We need more primary care physicians. And we need them to do a better job, not just make more money for corporate healthcare systems.
This study shows that female physicians spend more time with patients (time is a doctor’s most valuable resource) yet generate less revenue. In our current healthcare model, less revenue = less valuable physician. But from what matters to patients and their health, time spent with patients is probably a surrogate for higher quality of care, more empathic listening, and more collaboration with patients on what truly matters to them.
Yet another example of why we need more primary care doctors, more time with patients and why direct primary care is a superior model to what we currently have.
Dr. Hagopian was interviewed for a nice article on INSIDER.com about how to relieve stress, especially during a pandemic.
Key takeaways:
Can you prevent the stressor? If it’s COVID-19, no. But if it’s something that you CAN address, hit it head on.
Exercise is key. It doesn’t have to be anything fancy but even 10-20 minutes 3-4 times per week of regular aerobic activity such as walking is a start to decreasing stress levels.
Right now, more than ever, social connection is imperative since humans are social creatures. Make sure you connect with friends, family, and loved ones because while many of us may be physically distant, we can still be socially close.
Other healthy life choices are also important, such as limiting processed foods and sugar, getting plenty of sleep, and maintaining a relaxation practice such as yoga or meditation or even just a couple of minutes every day of focused deep breathing.
The CDC recently updated its guidance to suggest that certain patients who were previously recommended to get a COVID test now be suggested to consider not being tested.
This will certainly lead to fewer patients being tested and in Maine, that’s probably OK in most situations. But ultimately, these important decisions are made at the doctor-patient level and no sweeping recommendation will ever apply to every individual.
With testing, patients get answers about COVID but testing also leads to isolation, missed days from work, and financial implications.
If you have a question about whether or not you should get a COVID test, just ask us! We make sure our patients are fully aware of all the risks/benefits of testing, all while keeping public health in mind.
We are only starting to see the medium to long-term implications of COVID-19. The possible scariest one is myocarditis, inflammation of the heart muscle. It seems like a lot of people get it but we don't know how severe it is or how long it lasts. This is why we must remain vigilant to protect ourselves, our families, and our communities.
Please keep masking up.
Last week, I had the pleasure of seeing three new patients all on the same day. I was able to spend an hour with each of them. During that time, we reviewed their medical concerns but also their backgrounds, family lives, and where life was taking them next. We discussed their hopes, dreams, insecurities, trauma, and the winding course of life.
These types of long discussions are integral to understanding patients and how best to help them heal. But I left feeling completely nourished as a doctor. These long discussions with people are invigorating.
THIS is what healthcare is supposed to be for both patients and doctors.
The most valuable thing I can give my patients is my TIME. While I used to be encumbered by 20-30 minute slots (which weren’t really 20-30 minutes quality time with the patient but more like 10-15 spent staring at a computer screen), direct primary care has allowed me to spend… as much time as the patient needs so that we both feel good about the plan. It’s usually about 30 minutes of uninterrupted focus on the patient’s needs but sometimes it’s 60 or even 90 minutes. And it’s great!
This type of quality is impossible in our current system, which is built on patient turnover, volume, and treating people like a number, all in the name of the dollar bill. The only way forward is to give the reins back to the patients and the doctors.
I’ve had the opportunity to do some house calls in my new practice, something I was told would be almost impossible in my old practice. And house calls are AWESOME! Seeing patients in their own environment and having them invite me into their home is a privilege.
Today, I saw a young man in his backyard. I brought my sweet medical backpack full of anything I might need for a house call (from stitches to a blood pressure cuff). We chatted by the pool, I did an exam inside, and I answered all of his and his family’s questions… all in the comfort of THEIR space.
This type of patient-centered care has been sorely lacking for a while and it’s time we made it more commonplace, especially when mobility is limited during a pandemic. Being able to do what the PATIENT needs (not what the insurance company needs) and meeting them where they are at makes me proud to be a direct primary care physician.
A friend and I had a nice discussion this afternoon about how he could optimize his home workspace to reduce his chronic shoulder and back pain.
My first thoughts went to some basic ergonomic science, specifically, this article and this image.
Check these out and if you haven’t already, optimize your work-from-home space during what is expected to be a long haul of work from home during this pandemic.
Intermittent fasting really works! This, coupled with eating more healthy fats (nuts, avocados, salmon, medium-fat dairy), medium protein, and limited carbs has dropped me 15 lbs in 3 months. I feel better, have less hunger, and have much less desire to eat/drink items with tons of crappy sugar.
At some point this summer, I plan to try a full week.
I cannot recommend this book enough.
https://www.amazon.com/Complete-Guide-Fasting-Intermittent-Alternate-Day/dp/1628600012
While metformin is the best diabetes drug out there (it's based on the goat's rue plant - Mother Nature always makes the best medicine) for those that need medicine, it's no good with carcinogens in it. Time to chuck the extended-release metformin and get a new supply.
After putting on some stress weight at the end of last year and becoming classified as overweight, I've been on a kick of intermittent fasting for the past 3 weeks. I've dropped about 10 pounds, have become less hungry by eating healthy fats and meals that keep me nourished, and overall feel better (more mentally sharp, more energy, fewer aches and pains). Sure, I get a bit hungry but not nearly as much as I thought I would. And yes, I make sure I cheat once in a while because life is for living.
For those interested, start with this book and get in touch if you want to give it a try.*
*I do recommend talking to a doctor before embarking on your own fasting journey.