Travel has fully returned, and many patients are planning international trips again with a wide range of destinations and styles. The conversations in clinic often begin with questions about vaccines or antibiotics, but the real foundation of travel medicine is understanding the specifics of the trip. When I talk with someone preparing to travel, I start with where they are going, how long they will be away, what kind of environment they will be in, and whether they have chronic conditions that might influence risk.

For many women, menopause care has long been an afterthought in traditional medicine. The conversation often starts late, if it happens at all. Now, thanks to telemedicine, that’s beginning to change. Over the last few years, virtual menopause clinics have emerged to fill a long-standing gap in women’s health. Clinics like Midi Health and Menopause RX connect women directly with clinicians trained in menopause care.

Women often come to their primary care provider with vague but frustrating symptoms. Trouble sleeping. Brain fog. New anxiety. Irregular or heavy periods. Weight creeping up despite no major changes. Sometimes joint pain, palpitations, or new migraines. Many times, the provider and the patient both suspect something hormonal, but the connection to menopause is not always recognized right away. It is not that primary care clinicians do not care.

When patients ask me about compounded weight loss drugs like semaglutide and tirzepatide, I take a deep breath. The topic is complicated and keeps changing. It’s tempting to say, “Just avoid them,” but the truth is that patients are already looking for these options. Our job is to help them navigate the risks safely. Dr. Beverly Tchang’s “swim safely” analogy fits well.

Most people losing weight eventually run into a plateau. It can feel frustrating when the number on the scale stops moving, especially after months of effort. The important thing to know is that plateaus are normal. They’re not a sign you’re doing something wrong. They’re the result of biology. At a lower body weight, your body burns fewer calories. Hormones like leptin also shift in ways that make you hungrier and slow down further weight loss.

Binge Eating Disorder, or BED, is one of the most common eating disorders I see in practice. It is defined by repeated episodes where someone eats a large amount of food in a short period of time while also feeling a loss of control during the episode. It’s not just eating a second helping at dinner or enjoying dessert. These are episodes that feel compulsive, where the person cannot stop even when full or uncomfortable.

Night Eating Syndrome (NES) is one of those conditions that many patients and even some clinicians overlook. It isn’t the same as snacking after dinner once in a while. NES is a recognizable eating disorder where the timing of food intake is shifted into the evening and nighttime hours. People with NES may feel embarrassed or dismiss it as a bad habit, but it has real consequences for weight, sleep, and overall health.

Patients and colleagues ask me often about the cost of GLP-1 medications when insurance does not cover them. Wegovy and Zepbound are both FDA approved for weight management, but many patients run into the same barrier. Their insurance plan excludes the drug entirely. In those cases, people end up paying cash, and the list price can be thousands of dollars a month.

As physicians, we’re now starting to see questions about the newly approved 2025-2026 COVID-19 vaccine. The FDA has officially authorized the updated version. That’s the first step. The next step usually comes from the Advisory Committee on Immunization Practices, or ACIP, which sets the vaccine schedule for the CDC. At the moment, ACIP has not yet issued its formal recommendations for this updated vaccine.

In the last week, two of my medical school classmates reached out to me. One is an emergency room physician. The other is a dermatologist. Both wanted to talk about telemedicine and whether they should make the transition. Their questions reminded me of my own when I started, and it got me thinking about how different this kind of work really is compared to in-person care.

Telemedicine has become part of everyday care, and for good reason. It allows patients to connect with a physician from the comfort of home, at work, or even while traveling. Many problems can be managed safely and effectively through video visits. But not everything belongs in a virtual setting. As physicians, we follow guidelines—like those used by Teladoc, MDLive, and Amwell—that help us decide what can be safely managed online and what must be seen in person.

Gabapentin is one of the most commonly prescribed drugs in the U.S. It’s often used for nerve pain, seizure disorders, and sometimes off-label for sleep or anxiety. Many patients I see have been on it for years. Most of the risks we talk about are dizziness, fatigue, or potential misuse. Now there’s new research raising concern about its possible link to dementia.

When I talk with patients this week, many ask me: “Is the new COVID-19 vaccine out yet?” The answer, as of late August 2025, is that updated shots targeting the LP.8.1 subvariant have been approved by the FDA and are expected to be distributed this fall—but not everyone will be able to get one. The FDA has cleared vaccines from Pfizer, Moderna, and Novavax.

I’ve had several conversations recently with colleagues who are seriously thinking of leaving the U.S. to practice in Canada. This shift isn’t happening quietly. The interest from U.S.-trained doctors wanting to head north has jumped dramatically in recent months, and the reasons go beyond administration changes and healthcare policy. Before the recent political landscape, American physicians still looked at Canada as an appealing option.

I often see patients who come in complaining that one of their fingers gets stuck when they try to bend or straighten it. They’ll describe how the finger locks in a bent position, and when they force it straight, it pops painfully back into place instead of moving smoothly. This is what we call trigger finger. It’s a type of tenosynovitis, which means inflammation of a tendon and the protective sheath around it.

Menopause is one of those topics that comes up often in clinic, but it’s still an area where many patients feel unsure of what to expect. It helps to start with definitions. Perimenopause is the transition period before menopause. Hormone levels fluctuate, and cycles can become irregular. This phase can last several years. Menopause itself is defined as twelve straight months without a menstrual period, and the average age in North America is around 51.

In recent years, more family physicians—including myself—have pursued an additional board certification in obesity medicine through the American Board of Obesity Medicine (ABOM). At first glance, it might seem like just another credential. But in reality, this certification reflects a significant shift in how we approach one of the most pressing health issues of our time: obesity and its related metabolic conditions.

Whether you’re camping in the Rockies, traveling through Southeast Asia, or just enjoying a summer evening on your porch, one small insect could put your health at risk: the mosquito. In this excellent video by the World Health Organization, we’re reminded that mosquitoes are not just a nuisance—they’re the deadliest animals on the planet, responsible for more than…

As a physician, I often hear patients ask, “Why can’t I just eat less and lose the weight?” The truth is, it’s not that simple. Modern science has shown that obesity is a complex, chronic disease influenced by far more than diet and exercise alone. Your brain plays a central role in this process, and understanding that role is key to developing effective, compassionate treatment strategies.

Semaglutide, a GLP-1 receptor agonist marketed as Ozempic and Wegovy, has transformed the management of type 2 diabetes and obesity. While its efficacy in glycemic control and weight reduction is well-established, emerging reports highlight rare but significant adverse effects, including nerve and muscle pain. Clinical Presentations Allodynia (Skin Tenderness): A case series reported four patients who developed allodynia—pain from normally non-painful stimuli—after escalating semaglutide to 2.4 mg weekly.

As we move further into 2025, many hoped that SARS-CoV-2 would fade into the background. But viruses rarely follow the scripts we write for them. The newest COVID-19 variant, NB.1.8.1, has been gaining traction globally, warranting our attention as healthcare professionals and members of the community. While not currently classified as a Variant of Concern (VOC), its increasing prevalence and distinct features suggest we should remain vigilant.

When patients talk about weight loss, they often focus on the number on the scale. But as physicians, we know that what’s lost matters just as much as how much is lost. Are we losing fat, muscle, or both? This distinction—known as body composition—has major implications for health, function, and longevity. Research led by Dr. Dympna Gallagher and colleagues sheds light on how body composition shifts during weight loss, and how…

Many of my patients express frustration over a common pattern in weight management: they work hard to lose weight, see some progress, and then—months or years later—the weight returns. This pattern of losing and regaining weight is often called weight cycling, and it’s not only common but also emotionally and physically complex. As healthcare providers, we’ve often been asked: …

As both a physician and advocate for sustainable lifestyle interventions, I often get asked: How important is exercise for weight loss? The answer is, it depends—on your goals, your consistency, and how you define success. Thanks to decades of clinical research, including extensive reviews and randomized trials, we now have a clearer picture of the role physical activity plays not only in losing weight but in keeping it off.

Aging is inevitable, but the pace at which we age may be modifiable. One of the most promising areas of research in slowing the aging process and enhancing metabolic health involves the manipulation of how, when, and how much we eat. From calorie restriction to intermittent fasting, the landscape of dietary interventions is rapidly evolving—and the evidence is catching up.