An Interview with Dr. Ailene Medalla This is Part III of our "Getting to Know Your Doctor" series.  In this interview, we get to sit down and introduce Dr. Ailene, who was our Chief Resident during our residency training, and has recently joined our practice. (Many of these questions have come from reading Tim Ferriss’s book, Tribe of Mentors).  Enjoy! Dr. Ailene Medalla is Board-Certified Family Medicine Physician at Defiant Direct Primary Care in Williamsburg, VA. What’s an ideal Saturday like for you? Sleeping in, first of all.  So when I read yours about waking up at 5 ..read more

A Primer on the Latest in Cardiovascular Disease Prevention It’s up to doctors to always have a hand on the pulse of the latest medical information, assessing whether the studies coming out represent a meaningful change in how we should best care for patients. No place is this clearer in my mind than when measuring cholesterol. Why High Cholesterol Matters Measuring cholesterol is important because high cholesterol is: a silent killer, a common disease, and a condition we can actually do something about. High cholesterol is one of the first major steps on the path to heart disease, oth ..read more

Clipboards and Waiting Rooms Are a Thing of the Past For most people, when seeing a new doctor, they’re used to a quick, 15-minute “in-and-out” visit, at most.  And if that’s the case, a new-patient appointment with us will be unlike anything they’ve ever experienced. In our practice, things are different.  Greeted at the Door You’ll notice that there’s no waiting room, because patients don’t wait; we greet you right at the door.  You may also notice that there’s no clipboard with pages of symptom questionnaires, and no cup filled with pens of questionable cleanliness.  You ..read more

How a Five-Minute Conversation with a DPC Doctor Can Save You $5000 [Note: Any information that would appear to identify a patient has been altered to protect patient privacy]. I had a patient a few months back who needed an MRI.  She had seen a specialist who evaluated her and gave her an order slip for some lab tests and imaging studies. When I called the patient after the appointment, she was concerned about how much everything would cost. In the conventional healthcare system, this conversation ends with, “I don’t know, let’s just see what your insurance will cover, (and hope for the ..read more

Why Doctors’ Offices Run Like Broken Factories Have you ever experienced this? You get up early to make a morning appointment with your doctor.  You walk into the clinic, stand in line, and wait for the receptionist to check you in. “9AM appointment with Dr. Smith,” the front desk confirms, as you’re given a questionnaire to fill out on a clipboard while you wait.   But as you turn to find an open seat in the waiting room, you hear the receptionist speaking to the person behind you in line: “9AM appointment with Dr. Smith.”  Wait, what? You heard it right; that was not deja vu ..read more

20 Questions with Dr. Christina Mutch This is Part II of our "Getting to Know Your Doctor" series (see Part I, here). The tables have turned, and now I get to ask Christina a bunch of questions.  (Many of these questions have come from reading Tim Ferriss’s book, Tribe of Mentors).  Enjoy! In the last five years, what new belief, behavior, or habit has improved your life? Okay, so in my late teens and early twenties, I used to think that being a runner meant eating whatever you want.  Like most students, I ate a lot of processed foods.  But eventually, I somehow stumbl ..read more

20 Questions with Dr. Jake Mutch Christina and I recently came across some great questions in Tim Ferriss’s book, Tribe of Mentors.  This is an excerpt from a session where Christina sits down and peppers me with questions (adding a few of her own) over ramen.  Consider it Part I of our “Getting to Know Your Doctor” series.  Enjoy! What book would you be most likely to give as a gift? There are so many great books, and the better I know someone, the more tailored the recommendation.  But, okay, if there were only one, then it would have to be Essentialism: The Discipli ..read more

Why the Conventional System Doesn’t Communicate Many practices these days are starting to implement "patient portals." By logging in, you can ask a question, and it goes to the doctor for review. Or does it? Remember the last time you messaged your doctor? You had a concern, you sent the message, and then...crickets.  Or maybe a nurse chimes in and asks you to schedule an appointment to discuss further. Why the delay? Why the appointment?  That message you sent “to your doctor” was probably routed to a member of the clinic staff, and then had to be forwarded up the chain a few days l ..read more

The Right Combination of Old-fashioned Medicine and Modern Tech In America, health care has been notoriously difficult to acquire and navigate. There are so many backwards reasons for how things got this way, but suffice it to say, enough is enough. We live in the modern age, one with self-landing rockets and self-driving cars. The world's combined knowledge is one finger swipe away. An app can book you a hotel and plane ticket to almost anywhere on this planet. We have more access to information and an audience at our fingertips than the leaders of the world in 2000. Yet, despite all this tec ..read more