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Concierge Medicine Is Here and Growing!!

An increasing number of primary care physicians are downsizing to a concierge medical practice (also termed “retainer-based medicine”). In a concierge medical practice, the physician limits the number of patients in his practice and offers exclusive services for an annual fee. The patient pays a surcharge for increased access and additional services from their physician.1 […]

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Joseph S. Alpert, MD

Polypharmacy in Elderly Patients: The March Goes On and On

Polypharmacy is a major public health problem in the United States and abroad. Although there is no standard definition of polypharmacy, I see and recognize it every day in the outpatient and inpatient environment. A typical example that I saw yesterday was an 84-year-old man admitted to our internal medicine service for worsening heart failure. […]

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False and Misleading Information About Lyme Disease

  Recently, there has been considerable interest in the topic of fake news. For infectious diseases physicians, false and misleading information about the diagnosis and treatment of Lyme disease is not new. It is increasing in frequency and prominence, creating much confusion among primary care physicians and their patients. Persistent, unexplained subjective symptoms such as […]

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Where Have the Generalists Gone? They Became Specialists, Then Sub-Specialists.

At the onset of the 20th century, most practicing physicians had received their training in proprietary medical schools, many of which were essentially diploma mills.1 These schools offered a series of lectures over a 1-year period. A minority of physicians had attended university-based medical schools such as Johns Hopkins, which was established in 1893. There were only […]

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Dr. Joseph S. Alpert

Will Physicians Stop Performing Physical Examinations?

In the 21st century, debate continues concerning the value of the physical examination.1, 2, 3, 4 That such a hallowed and respected ritual of clinical medicine should even be questioned is the result of the remarkable advances during the last 50 years in imaging technology and laboratory medicine. When I was a student and resident in the late 1960s […]

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