I hear a version of the same story often. Someone starts a GLP-1 medication, feeling hopeful, and within a few weeks, they're either not losing anything or they feel so nauseated they can barely function. When they call their doctor, the answer is usually the same: give it more time, or you can move up to the next dose in a month (insurance dictates the refill timing). But, what I have found is there is much more nuance to dosing GLPs based on individual patient characteristi

In a previous post, I talked about the weight physicians carry inside a healthcare system built around volume instead of relationship. I lived that weight myself, and for a while, I thought seriously about walking away from medicine altogether. A doctor considering an exit My first job out of residency, I disliked so much that I had a running list of ways to get out. How little could I live on? What else could I do with my training? I spent most days tired and worn down. I st

[Rofeh]: רוֹפֵא a Hebrew word meaning one who restores health, or makes whole again Have you ever wondered what your doctor is really thinking while you're sitting across from them? Not the diagnosis, not the treatment plan, but what it feels like to carry the responsibility of your care. I want to give you a glimpse into that, because I think it changes how the whole relationship feels once you understand it. What healing really means Healers have shown up throughout nearly

Last spring I put more than 150 grapevines into the ground behind my house. I am a family doctor, not a winemaker, and I am still learning most of this as I go. But somewhere between digging holes, building a trellis, and learning to prune, I started to understand why this one plant has shaped so much of human history. It also kept circling back to the subject I care about most in medicine: how we live well, and how we live long. Most of what I write here will be about your h

You can do everything you think is right with sunscreen and still end up pink by dinner. That is the frustrating part. Most of the sun damage I see through a central Nebraska summer does not come from people who skip sunscreen altogether. It comes from people who use it, trust it, and never realize that a few small assumptions are quietly working against them. The most common sunscreen mistakes are not dramatic ones. They are quiet gaps in an otherwise good routine, and the g

You've cut back on food. You've tried to eat better. But the hunger doesn't stop. The cravings for something sweet, something salty, something high-fat show up anyway, sometimes minutes after a meal. And no matter how hard you push back, your body keeps pushing harder. If that sounds familiar, I want you to hear this clearly: it is not a lack of willpower. It is not a weakness. It is not a character fault. What you're experiencing has a name, a mechanism, and more importantly

We tend to file the stomach bug under winter. It shows up after the holidays, runs through the school, and we accept it as part of the cold-weather package. So when summer arrives and someone in your house wakes up with a fever, a sour stomach, and that unmistakable “I’m not right” feeling, it catches you off guard. Aren’t we supposed to be done with this until fall? Not quite. Summer has its own crop of viruses, and they behave differently from the ones you brace for in the

I've lost count of how many times a patient has sat across from me and said some version of the same thing: "I've tried everything. I lose some weight, and then it all comes back. I don't know what I'm doing wrong." Most of the time, they're not doing anything wrong. They're following advice that was never built for their body in the first place. Generic diets, calorie apps, and one-size-fits-all plans can produce short-term results. But they almost never address the mech

I have a lot of patients who come in feeling like they're aging faster than they should. They're in their 40s or 50s, they're doing everything they think they're supposed to do, and yet they're tired, slower to recover, carrying weight they can't shake, and starting to worry about what the next few decades look like. What they're describing isn't just getting older. It's a gap between how old they are and how well their body is functioning. And that gap is exactly what long

If you find yourself raiding the kitchen long after dinner, not because you're hungry, but because you can't seem to stop, you're not alone, and you're not lacking willpower. For many people asking, "Why do I eat at night even when I'm not hungry?" there's likely a physiological answer. What you might be dealing with is a real, clinically recognized condition called Night Eating Syndrome (NES). And like most challenges I see in my office, the solution starts with understandin

The health benefits of exercise I talk to patients every week who know they should exercise more, but either don't know where to start, feel too busy to prioritize it, or have tried before and given up. I understand that. Life is full. But I also know this: no medication I can prescribe does what consistent physical activity does for the human body. Exercise isn't a supplement to good healthcare. It is healthcare. The research is there. Regular physical activity improves meta

Healthcare costs can quickly add up, especially when you need regular checkups, chronic condition management, or preventive care. Traditional insurance-based models often involve confusing billing, long wait times, and limited doctor access. This can leave you feeling frustrated and unsure about your health decisions. Affordable healthcare services are about more than just saving money. They mean getting quality care that fits your budget and lifestyle. Imagine having a docto