I first met Mr. B. during my internship, when he was a 29-year-oldmusician who had been admitted to the hospital with atypicalpneumonia. After he was discharged, he kept his follow-up appointmentwith me, and I became his primary care physician. During thenext 10 years, he succeeded in stopping smoking, and his majorconcern was his lack of steady employment. Just before turning40, Mr. B. developed idiopathic thrombocytopenic purpura (ITP).His thrombocytopenia responded to corticosteroids, but it recurredwhen the dose was tapered. Between the medication and the uncertainty,he became depressed.
Dr. Woo is a primary care physician at Brigham and Women's Hospital and an associate professor of medicine at Harvard Medical School both in Boston.
An interview with Dr. Woo can be heard at www.nejm.org.
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The State of Primary Care
Chretien J. H., Das R. R., Moorthi R. N., Becker K. L., Carleton S., Lin G. I., Poplin C., Oserman S., Fields L. S., Kirk L. M., Bodenheimer T.
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N Engl J Med 2006;
355:2595-2598, Dec 14, 2006.
Correspondence
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