On the economy of attention
Why we walked out of seven-minute medicine. The math of the visit, the math of the panel cap, and what attention is actually worth in a fee-for-service economy.
Buprenorphine without theater
A working primary-care framework for opioid use disorder treatment after the X-waiver. The framework is the medication; the rest is logistics.
Perimenopause as a data problem
The transition is not subtle. The information primary care has historically given members about it has been. A stand on what we know, and what we are willing to say we don't.
The March cold-snap debrief
Notes from the post-Birkie clinic. Thirteen members raced; one fractured a wrist; nobody got frostbite. What worked in our pre-race counselling and what did not.
Why we list our prices
A reply to the most-asked question at the open house. American healthcare is the only sector in which not knowing the price has been treated as evidence of seriousness.
Notes on listening
A long visit at the end of life is a different visit. What changes and what doesn't, written from the front of the room.
A note on the form
The transcripts are not blog posts. They are working documents. We use them when a clinical question keeps coming up in visits and we'd like to write the answer once instead of three hundred times. They are signed. They get revised. They cite their sources. When we are wrong, the next transcript will say so, by name, with a date.