Itchy behinds are part of my everyday. It shouldn’t be part of yours.
Itching on your bottom is usually a minor annoyance, but it can be debilitating. A patient of mine was unable to work because his derrière itching was so intense. A common cause of itching bottom, called pruritus ani, is allergic contact dermatitis.
Places where your skin transitions from outside to inside, such as the lips or the anus, are susceptible to dermatitis because your skin’s barrier is limited in these locations. Without a thick layer of keratin, irritants on the outside easily get into your skin. Moist toilet tissues, such as baby wipes or towelettes, might seem to get you cleaner than old-fashioned toilet paper, but chemicals in the wipes cause a rash in some people. Read more »
I seem to have had a run on bereavement recently, in that I’ve had several patients who have lost loved ones. Some have wound up in my office for unrelated complaints, only to have the grief spill out. I’ve become aware of the struggles of others via Facebook.
I’ve found this handout (from Family Practice Management several years ago) to be very useful. I keep copies in my office and hand them out when needed, but it occurs to me that having another way to disseminate this helpful information would be a good idea. Read more »
I lost a patient this season, an infant, to whooping cough (pertussis). After falling ill, he lived for nearly a month in the intensive care unit on a ventilator, three weeks of which was spent on a heart/lung bypass machine (ECMO) due to the extent of the damage to his lungs. But all our efforts were in vain. The most aggressive and advanced care medicine has to offer couldn’t save his life. The only thing that could have saved him would have been to prevent him from contracting pertussis in the first place.
He was unvaccinated, but that was because of his age. He was part of the population that is fully dependent on herd immunity for protection, and that is exquisitely prone to a life-threatening course once infected. This is a topic we’ve coveredad nauseum, and I’m not inclined to go into greater depth in this post. Suffice it to say his death is a failure at every level. We, both as medical professionals and as a society at large, need to do a better job of protecting our children from preventable diseases. Read more »
Thank you for your consideration of my profession for your career. I am a primary care physician (PCP) and have practiced for the past 16 years in a privately-owned practice. (At some point I intend to stop practicing and start doing the real thing. It amazes me at how many patients let me practice on them.)
Anyhow, I thought I’d give you some advice as you go through what is perhaps your biggest decision regarding your career. Like me, you probably once thought that choosing to become a doctor was the biggest decision, but within medicine there are many options, giving a very wide range of career choices. It is the final choice that is, well, final. What are you going to do with your life? ”Being a doctor” covers so much range, that it really has little meaning. Dr. Oz is a doctor, and he has a very different life from mine (for one, he’s not the target of Oprah’s contempt like I am -– but that’s a whole other story).
Here are the things to consider when thinking about primary care:
1. Do you like talking to people who are not like you?
Primary care doctors spend time with humans -– normal humans. This is both good and bad, as you see all sides of people, the good, bad , crazy, annoying, funny, and vulnerable sides. If you see mental challenge as the main reason to do something, and would simply put up with the human interaction in primary care, don’t do it. The single most important thing I have with my patients that most non-PCPs don’t have is relationship. I see people over their lifetime, and that gives me a unique perspective.
2. Do you prefer variety over predictability?
Every room I walk into is different –- often vastly different -– from the last. I could be walking in on a crisis or a stable recheck. The person could be elated or crying. They could be 90 years old or two days old. They could have something wrong with any system, and it could range from mild to life-threatening. I’d go nuts doing the same thing every day, be it looking just at skin or just dealing with the kidney. But some folks do better with routine and a lack of surprise, they don’t want their days to be unpredictable. Read more »
Doug Farrago is a family physician in Maine and the editor of the entertaining Placebo Journal. He uses his Placebo Journal media platform to show his audience what primary care is all about. In this video, “Doug Unplugged,” Dr. Farrago gives us a little taste of that journey. Hollywood, take notice.
*This blog post was originally published at KevinMD.com*
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Itchy behinds are part of my everyday. It shouldn’t be part of yours.
I seem to have had a run on bereavement recently, in that I’ve had several patients who have lost loved ones. Some have wound up in my office for unrelated complaints, only to have the grief spill out. I’ve become aware of the struggles of others via Facebook.
