Diseases of Despair

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Much of my work and much of the public’s attention in the last several years has been focused on the opioid crisis, and properly so.  But addiction (or substance use disorders) are the result of a complex mix of genetics, environment and exposure to the substance. The environment includes the stability of the household and… Read more »

Take A Deep Breath … Or Not

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For the past 49 years the American Academy of Family Physicians (AAFP) has taken a formal policy stance that has championed clean air, clean water and clean land as vital to public health. The mission of the Environmental Protection Agency (EPA) is to “protect human health and the environment” by “working to ensure that Americans… Read more »

High-Way Driving

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I was alarmed in February when I read reports of a study performed by the Governors Highway Safety Association (a national group) which showed that while pedestrian fatalities decreased by 6% in the first 6 months of 2017 compared to the first 6 months of 2016, in the 7 states with legalized recreational marijuana pedestrian… Read more »

No Good News

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In December the CDC released updated data on trends in deaths from drug overdose between 1999 and 2016 and, as you might imagine, there is nothing good about it. Anyone paying attention knows it is getting worse, but this data from the National Vital Statistics System also gives us insights into specific groups, geography and… Read more »

Wrong Way

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Each year United Health Foundation releases “America’s Health Rankings”, which is an overview of the status of our health as a nation and a ranking of states, and there are concerning trends across our country and in Maine’s performance relative to other states. In the US premature deaths  are up 3% just since 2015, drug… Read more »

The Affordable Care Act

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The passage of the Affordable Care Act in 2009 (signed into law in March of 2010) was a watershed moment in US history. Regardless of your perspective on the politics of that debate and its outcome, it has had a dramatic impact on healthcare in the US. One metric of that impact is the number… Read more »

Integrated Model of Primary Care

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PCHC has been a national leader in the development of what is known as the “integrated model of primary care”.  That is, in addition to a primary care provider and their team, our patients also have access to mental health providers (psychotherapists and psychiatric specialists) and their care is coordinated and communicated in a manner… Read more »

National Recovery Month

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September is National Recovery month and a fitting time to think about our the challenges we face in our country and our region related to substance abuse, to recognize the great work and resources we have and are building to meet this challenge, and to celebrate and support the people who are succeeding in recovery…. Read more »

Cherchez la Médicament

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As a student and early in my career I had the wonderful opportunity to work with my father, who was also a family doctor.  If there was one lesson that he burned into my brain it was that when things weren’t going well for the patient “cherchez la médicament” –  look for the medicine (he… Read more »

Inequality in America’s Health Care System

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Although America’s health care system is often touted as “the best in the world” that is demonstrably untrue. A recent study published in Health Affairs magazine, however, indicates that we are a world leaders in one area of healthcare: inequality. The difference between rich and poor as it pertains to access to care and health… Read more »