Family physician, author, blogger, speaker, physician leader.

Recent Articles

To Repair or Replace a Flat Tire?

“Daddy, I think we have a flat tire.” I just rolled out of the garage with my 4th grade daughter. It was Tuesday morning. Usual daily routine. Drop her off at school then go to work. A little different today as I was to lead an important meeting. How could she possibly know what a flat tire sounds like? Now? Right now? She’s probably mistaken. It can’t be a flat tire. “Whopp, whopp, whopp.” The car was tilted down towards the passenger side. Rats! Not good. Never a good time to have a car problem. Get out of the car. Yep, flat tire. Ask daughter to get out of the car. Wife hasn’t left for the office yet. Can she take her to school instead? Call the auto club for help in changing the tire. If quick enough, I might still make the meeting without getting dirt and grime all […] Read More »

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My Advice to Medical Students – Better Care Is Mindfully Listening To Your Patient!

“Dr. Liu, I don’t think he has diverticulitis.” So said the 2nd year medical student. She had just completed her first year of anatomy, biochemistry, pathology, and introduction to doctoring at the local medical school. One of the sharpest med students I’ve proctored. Like many summers, I’ve been fortunate to spend time with the next generation of doctors. These future doctors were brimmed with enthusiasm and energy.  Instead of taking time off to relax before second year, eyes bright and eager to learn they decided to devote more time with patients. I remember putting on a similar short white coat, stuffing my pockets with a stethoscope, reflex hammer, pens and notepad, and hoping to somehow look the role even if I still didn’t feel quite up to the role. As a practicing primary care doctor and local community preceptor, I don’t always feels quite up to the role as an […] Read More »

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Make the Most Out of Your Doctor Office Visit – You Just D.A.T.E.D. Your Doctor!

Book excerpt from The Thrifty Patient -Vital Insider Tips for Saving Money and Staying Healthy You Just D.A.T.E.D. Your Doctor You’ve told your story. Your doctor gets it. He has completed the physical exam. He formulates a plan to get you better. The next skill you should master may be as important as being a great storyteller. Your doctor has told you the treatment plan. Do you remember what you need to do? A 1996 study at the Mayo Clinic showed that patients remember less than half of what physicians tell them during office visits.7 Of nearly six hundred patients who were asked to recall what diagnoses physicians had discussed with them, 54 percent could not remember the major problems. Of patients whose doctors had discussed with them the risk factors for heart disease, 68 percent did not recall any discussion about tobacco use, 62 percent did not remember hypertension […] Read More »

Why Nurse Practitioners Should Not Do Primary Care Without Physician Oversight

“She said my back pain was caused by micro kidney stones.” So said my newest patient after her previous primary care provider, a nurse practitioner retired. “Micro kidney stones?” I didn’t know what else to say. Having practiced as a board certified primary care doctor for a decade, I’d never even heard this term. So the NY Times opinion piece that “Nurses Are Not Doctors” resonated with me. The fact that 17 states have legislated nurse practitioners the right to practice primary care medicine without physician oversight is very worrisome. There is a primary care crisis. We do need more primary care providers. Though nurse practitioners can fulfill some of the demand they cannot do so without doctor oversight. Though on paper it seems like what primary care doctors do is easy, in fact when digging a little deeper, one finds out these two specialties are not the same though […] Read More »

Would Doctors and Patients Pick a Better Health Care System If They Saw It?

we believe Integrated will triumph Fragmented every time – Steve Jobs, Apple CEO Two articles recently got my attention. The first was an interview by Dr. Robert Pearl, CEO of the Permanente Medical Group with my favorite author and thinker Malcolm Gladwell. On Pearl’s on Forbes blog, he answered Gladwell’s request to tell people what is was like to be a doctor. The second was a NPR article  “When Facts Are Scarce, ER Doctor Turns Detective To Decide On Care” by Dr. Leana Wen, patient advocate and author of the book When Doctors Don’t Listen. Both articles reminded me how doctors and patients have different realities simply by where they practice. As a practicing primary care doctor in an integrated health care system, which is partnered with a physician led medical group, these stories were quite foreign to me. These stories were once my reality in residency but no longer […] Read More »