HeyJaredA Country Doctor Writes:
Notes from a doctor with a laptop, a housecall bag and a fountain pen. Day-to day and career reflections from a 1979 Medical School graduate practicing on Maine's Canadian border.
- Indexed issues, last 90 days
- 12
- Latest publication
- Sep 26, 2026
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- Jul 22, 2026
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No Choice But to Move On (opens the original)
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<img alt="" class="sizing-normal" height="1092" src="https://substackcdn.com/image/fetch/$s_!V8cM!,w_1456,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2Fa8b91c3f-99b2-433a-9e29-c150ee80ae23_4032x3024.
A Moving Target (opens the original)
Physical Examination for Asymptomatic Adults? (NEJM) (opens the original)
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This weeks New England Journal of Medicine has an article titled Physical examination for asymptomatic adults It describes a clinical scenario where a 60-year-old male presents for a routine visit with normal vital signs, up-to-date screening history and no concerns or symptoms. I think we all know that the evidence favoring in depth routine physical exams in people with a negative review of symptoms is by now fairly nonexistent. But the article includes opinions from two different doctors about
Pen and Paper Medicine: Housecalls are Especially Old Fashioned Without Internet Access (opens the original)
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First in a new series for my paying subscribers about where I am in my career and where I'm headed. Read more
Some Doctors are Like Bag People (opens the original)
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Bag people, we’ve all seen them, pushing grocery store carts with what seems to be all their earthly belongings. That’s what I think of when I read some medical charts. Back when we were dictating office notes to be transcribed, I often read initial paragraphs summarizing a patient’s entire past history with smatterings of relevant information like most recent colonoscopy if they were in the office for constitutional or digestive or related conditions. That can make a certain amount of sense but
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