Cardiology

No formal veterinary training. Lifelong pet owner, special attraction to golden retrievers. Personal success in leveraging dog companionship into meaningful health changes including weight loss, exercise, and even improved social skills. Not thinking along the lines of emotional support animal but rather true service animal with tasks directed at changing cardiovascular risk factors.

The rules that apply to medications should be the same regardless they come from a pharmacy/drug company or nature/health supplement.

Open Minded: always be willing to reconsider. If a natural herb can help with loss of appetite, nausea, anxiety or pain, should we not pursue its effective use.

Skepticism: show me the data. While the science behind THC is growing, the same cannot be said about CBD. Jumping on a bandwagon to pursue profits and not health, is what has lead to my frustration with “corporate medicine”. I want to reserve my expert medical recommendations to those area which are supported by evidence based data.

Take for example honey. I love the natural simplicity. When I review the positive data about its use as a cough suppressant and wound dressing, I will recommend it accordingly. The benefit of consuming local honey to reduce allergy symptoms, however has produced negative results and cannot be recommended or supported.

I am very interested in expanding our knowledge. To help address potential benefits and concerns, medicine needs the help from patients, preferably in a voluntary manner free from the bias of money.

I would like all patients who wish to pursue a “medical card” for cannabis use, to participate in the study. By referencing symptoms and diseases with treatments, the group can benefit from the individual experiences. For example, a patient with inflammatory bowel disease (IBS) and problematic diarrhea would potentially benefit from cannabanoid therapy. Which plant?, which chemical?, what method of consumption?. A registry is only the start, but take for example the following hypothetical data: for patients like you (IBS), we are following 10 other similar patients. If 7 out of 10 got benefit from inhalation of plant extract X and only 1 out of 10 got benefit from edible extract Y, where would you like to start?

Common chronic health problems overlap, but certain areas come with pitfalls. Some like erectile dysfunction overlap with the common problems of middle aged men, and I am very happy to provide risk assessment and Rx when appropriate. Other areas are just too overwhelming, like day to day diabetic management, which I will defer to others.

Not currently certified to perform CDL exams (commercial drivers license), but can foresee expanding in that area.

I do not like the issues associated with disability evaluations or chronic pain management with narcotics, though I would be happy to enroll chronic pain patients in a registry of alternative methods like cannabis.

To promote more face to face patient time, several factors are being modified. Keep overhead low. Eliminate fancy office brick and mortar in favor of mobile office in travel trailer. Reduce need for clerical support (data entry, billing and insurance), by having patients self enter data and paying cash. Expensive EMR’s (electronic medical records) replaced with simpler records featuring our ubiquitous cell phones.

The concern is reasonable. A clinical encounter should include review of systems/symptoms (ROS), a physical encounter involving vital signs and use of a stethescope (listening to sounds from the heart, lungs and abdomen), not just a screen encounter with a practitioner at a remote site. Legitimate documentation can be provided to the patient to share with other providers, and even submitted for possible reimbursement from insurance.