All Posts by Mark Foster, D.O.
Letters from the Front Lines
Dear Bob– Here’s a story of stark contrasts. I saw a man for a physical recently, mid-50′s. He was the picture of health, on no medications or supplements. He was an avid biker and outdoorsman, conscientious of his diet, great …
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April 10, 2012 | Categorized in: Blogs
Letters from the Front Lines
Bob– An encounter from this week: I saw a 24 year-old theater actress who was started on Lexapro nine months ago for a one-time “panic attack” and has gained sixty pounds since. This is extremely distressing to her as her …
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February 21, 2012 | Categorized in: Blogs
Letters from the Front Lines
Dear Bob– I’ve had a couple of remarkable conversations, not with my own patients, but with friends and acquaintances asking me for advice. Each example depicts so much that is wrong with the biomedical model of mental health care. First, …
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February 1, 2012 | Categorized in: Blogs
Letters from the Front Lines
Dear Bob– I met a new patient today, an African American gentleman in his late 40′s, a successful entrepreneur and innovator (invented and marketed his own garage organizer), who is having devastating health problems related to his heart and weight, …
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January 19, 2012 | Categorized in: Blogs
Letters from the Front Lines
Dear Bob– Last fall, I was filling in at a clinic for a provider who was on vacation, and saw a woman in her late 40s for this complaint: “Anxiety/depression worse, wants to go back on meds.” Prior to my …
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January 11, 2012 | Categorized in: Blogs
Letters From the Front Lines
Dear Bob– A disturbing case from this week. I was working at an urgent care and saw a fifteen-year old boy for the complaint of severe headache. Before even walking into the exam room, I was concerned as I looked …
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December 31, 2011 | Categorized in: Blogs
Healing the Body and Mind
My name is Mark Foster. I am a family physician and writer from Colorado, and the co-Founder and president of a new non-profit called ClearMind, Inc., dedicated to bringing consumers and professionals together to advocate and provide services for non-pharmaceutical …
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November 6, 2011 | Categorized in: Blogs | Tagged as: Anxiety
September 15, 2011
Dear Bob– As I share with patients my new perspectives on the ineffectiveness and potential harm of psychotropic drugs, I have found that many, even most people, are receptive to the idea. I’d say that about 25% of people are …
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September 15, 2011 | Categorized in: Blogs
August 4, 2011
Dear Bob– I saw a very nurturing woman a few months ago, quite obese, for the symptoms of chest pain and fatigue. She had been admitted to the hospital six days previously for the same symptoms. She’d had a thorough …
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August 4, 2011 | Categorized in: Blogs
July 12, 2011
Dear Bob– I want to share a case from this past week the reveals a disturbing misuse of stimulants in treating a poorly diagnosed case of ADHD. I was filling in at a local urgent care on a Sunday when …
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July 12, 2011 | Categorized in: Blogs
June 27, 2011
Dear Bob– I have been working again, taking temporary assignments filling in for other physicians and working in urgent cares while I get my practice re-established. It has been great to re-engage with real patients in the throes of life, …
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June 27, 2011 | Categorized in: Blogs, Pregnancy & Birth Defects
June 17, 2011
Bob– Here is a letter that I wrote several months ago in response to an early reader of my blog here. She expressed concern about the way I described my reaction to a patient who, in very poor mental and …
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June 17, 2011 | Categorized in: Blogs, Pregnancy & Birth Defects
April 30, 2011
Bob– I have found that many patients, and even many physicians, don’t appreciate the basic differences between psychology and psychiatry. For most of your readers, I suspect they grasp the sometimes profound divides between these disciplines. But for many patients, …
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April 30, 2011 | Categorized in: Blogs
April 11, 2011
Dear Bob– I want to share an email I received from a physician friend, who practices in a hospital-based specialty. He is highly intelligent, naturally skeptical, and thus interested in seeing for himself if there was any merit to your …
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April 11, 2011 | Categorized in: Blogs
March 29, 2011
Dear Bob– Since you posted about my termination last week, I’ve received a lot of words of support and encouragement, and I wanted to say thank you. Mental health reform is a cause I have come to deeply believe in, …
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March 29, 2011 | Categorized in: Blogs
Letters from the Front Lines
Bob– I want to share with you a success story that has played out over the last three months. I have been working with a woman in her mid-fifties who is wheelchair bound due to crippling arthritis and obesity. She …
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March 15, 2011 | Categorized in: Blogs
March 15, 2011
Bob– I want to share with you a success story that has played out over the last three months. I have been working with a woman in her mid-fifties who is wheelchair bound due to crippling arthritis and obesity. She …
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March 15, 2011 | Categorized in: Blogs
March 4, 2011
Bob– I’m going to share with you a case from today that did not involve psychotropics, but I think it illustrates an important point about the opportunity cost of reflexive prescribing. I saw a new patient today, a distinguished fifty-two …
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March 4, 2011 | Categorized in: Blogs
February 14, 2011
Bob– Recently, I saw a thirty-six year-old Bulgarian man for a follow-up visit. He is my age, with three children almost exactly the same ages as mine, so I felt an easy connection with him. He immigrated to the United …
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February 14, 2011 | Categorized in: Blogs
January 31, 2011
Bob– Today, I saw an intelligent and sarcastic teenage boy for renewal of his Adderall. He presented with his well-meaning but frustrated father, who is a retired military man and a disciplinarian. I was trying to draw the boy into …
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January 31, 2011 | Categorized in: Blogs
January 17, 2011
Bob– About a month ago, I started caring for a fifty-five year old Filipino woman. She speaks English well, though with a heavy accent. She is very sweet-natured, always painfully respectful of me and my authority as a doctor, and …
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January 17, 2011 | Categorized in: Blogs
January 7, 2011
Bob– This is the twentieth letter that I’ll be posting on your website. I thought I’d use the occasion to reflect on what I’ve observed over the past six months in regards to mental health care in my practice. It …
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January 7, 2011 | Categorized in: Blogs
December 22, 2010
Bob– Many cases I have shared with you have been interactions with patients who are seeking a healthier way of dealing with mood disorders, or who are open to having me challenge their core assumptions about medication usage. But perhaps …
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December 22, 2010 | Categorized in: Blogs
December 15, 2010
Bob– I saw a thirty-four year old woman today for a follow-up visit regarding post-partum depression. She delivered her second child two months ago, and she first came to see me two weeks ago for severe depression. Her primary symptoms …
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December 15, 2010 | Categorized in: Blogs, Pregnancy & Birth Defects
December 6, 2010
Bob- I saw a sixteen-year old girl for a sports physical today. She plays softball for the local high school and also is on the volleyball team. She gets good grades, takes honors classes, and serves in the student government. …
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December 6, 2010 | Categorized in: Blogs
November 26, 2010
Bob– Very interesting case today, a forty-six year-old woman, new patient, overweight, and very pleasant. She is someone who, at first glance, I never would have suspected was on antidepressants. She came in for some recent joint problems, and in …
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November 26, 2010 | Categorized in: Blogs
November 11, 2010
Bob– Today, I saw a bright, athletic lacrosse player who is a high school sophomore. She was seeing me to follow up on a mild concussion that she sustained last week during a lacrosse game. She is doing fine from …
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November 11, 2010 | Categorized in: Blogs
November 1, 2010
Bob– Since we’ve started posting these letters, I’ve had a number of readers responding to me and asking about my strategies for withdrawal. As you know, there really is no official guideline for this, and there are a lot of …
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November 10, 2010 | Categorized in: Blogs
November 9, 2010
Bob– Today, I saw a very friendly, highly intelligent (she has a PhD in economics) and overweight 34 year old woman for a refill of her Zoloft, which she had been on for the last twelve years, until about fifteen …
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November 9, 2010 | Categorized in: Blogs
November 4, 2010
Bob– Today, I saw a healthy, strapping young man, 28 years old and an avid recreational softball player. He is a former college athlete and plays in a couple leagues at once right now. He is fit and cheerful, has …
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November 4, 2010 | Categorized in: Blogs
October 28, 2010
Bob– I had an interesting case today. A friendly, 24 year old, very slender and slightly distracted Vietnamese woman who has a 18 month-old daughter. She has a tumultuous life, lots of boyfriend problems (not the father of her toddler), …
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October 28, 2010 | Categorized in: Blogs
October 25, 2010
Bob– A couple of weeks ago, I got a call from the mother of one of my teenage patients, a 14 year old Chinese-american boy who initially saw me at the start of the summer for a sports physical. At …
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October 25, 2010 | Categorized in: Blogs
October 21, 2010
Bob– I’m going to try to be quick today (unlikely), but I want to share two cases: 1) I saw a pleasant 32 year old woman who has suffered from intermittent depression and who had been on Lexapro several years …
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October 21, 2010 | Categorized in: Blogs
October 17, 2010
Bob– A couple of very positive patient encounters yesterday: • First, I saw a fit, vibrant 45 year old woman who presented for the first time complaining of knee pain. She probably has a meniscal tear of the knee. In …
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October 17, 2010 | Categorized in: Blogs
October 14, 2010
Bob– Had two very interesting cases this morning: First, I saw new patient, a very thoughtful, intelligent retired pastor who is on Citalopram. We were visiting about a number of other health issues, and he asked if I could refill …
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October 14, 2010 | Categorized in: Blogs
October 10, 2010
Bob– Today was full of psych stuff from the first patient to the last. Yes, these clinic days are representative of my typical practice. Just counted, and 9 of my 15 patients today had a significant psych component to their …
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October 10, 2010 | Categorized in: Blogs
October 6, 2010
Bob– Yet another challenging day. I had two more patients today whose trajectories would relate perfectly to Anatomy of an Epidemic. The first was an 61 year old man on three antidepressants (Wellbutrin, Remeron and Zoloft), as well as daily …
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October 6, 2010 | Categorized in: Blogs
September 25, 2010
Bob– My brain is still buzzing from my second day back in the trenches. My final patient today was a middle-aged woman who could have come straight from the pages of your book, but without the awareness yet of how …
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September 25, 2010 | Categorized in: Blogs
September 21, 2010
Dear Bob: Today, fittingly, was a very psych heavy day at my clinic. I saw the whole gamut of patient situations, patients (and their conflicted young doctor) who are swept up and away in this psychotropic-intensive paradigm of care. When …
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September 21, 2010 | Categorized in: Blogs
September 18, 2010
Dear Robert, I just finished Anatomy of an Epidemic while on vacation. I am a family physician (and writer) practicing in Colorado. For years, my practice has been drifting of its own accord towards a distrust of the psychiatric establishment, …
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September 18, 2010 | Categorized in: Blogs
September 27, 2010
Bob– I would guess that as I am typing this, you are in the midst of a spirited defense of your book at the conference. I hope that it goes well for you, and that your audience is receptive. I …
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September 10, 2010 | Categorized in: Blogs