Secure Email will be up at end of month:

After long delays due to server problems, we're finally going to have a functional secure-email system up and running at the end of the month. Earlier problems with our server were causing long (and possibly dangerous) delays. However, with our server-switch occurring at the end of the month, we will be putting up a new (and even more secure system). All submitted data is encrypted and requires a doctor's password, a patient-set pin number, and a decryption key to be read... and even in the unlikely event that an unauthorized person manages to access the database, without the proper decryption key, the entries will be completely unreadable.

New Website almost here:

Also at the end of the month, we'll be posting a new version of the website on a faster and more secure server. The new website will feature a section exclusively for patients, which will include detailed information on accessing the doctor and other office staff (including the secure email forms - see above), medical resources (articles, links, and guides), and a "billing help" section, which will host tutorials for understanding invoices and billing your insurance.

New Newsletter Format:

In addition to sporting a new look, the Doc-Talker newsletter is now more streamlined, more user-friendly, and more current. Expect new issues every month, with Dr. Rant, Dr. Rave and Dr. Reason as the centerpiece (see today's feature), accompanied by new periodical features.

The Vienna Times (archived in the Fairfax County Times) recently published a story on and Dr. Dappen, detailing the ideas behind the formation of the practice and how it compares to other medical services.
Read the full article here.

Introduction to a new column: Dr. Rant, Dr. Rave, and Dr. Reason

I humbly introduce c. They will be writing a periodic health care column together. They share a secret: They are all, in fact, the same person, but suffer from multiple personalities. Each month they will be talking with you about a specific health question.

Whether it be in sickness or in health, Dr's Rant, Rave, and Reason (Dr R³) have something to say. Sometimes they agree with each other. Usually they love to fight like cats and dogs. On the right shoulder sits Dr. Rant. He's the reductionist-science guy who cares only about the evidence from randomized studies, a real detective from Dragnet, Joe Friday, “Just the facts ma'am.” On the left shoulder sits a real cheerleader. Dr. Rave is the political voice of medical societies and the medical-industrial complex. He whispers messages of eternal hope to patients, while protecting the pocketbook of the medical system. Sitting in the center is Dr. Reason, the medical practitioner. While enduring the narrowly focused tirades of Dr Rant and paternalistic platitudes of Dr. Rave, he works to formulate a solution for you, juggling experience, training biases, situational stresses, time constraints, fear of litigation, among other reality checks.

Dr. Rant and Dr. Rave are policy wonks. They ignore the complexities of treating individuals. They formulate statements about the ‘forest,' then step back to let Dr. Reason help each ‘tree' to understand and interpret their messages--a real challenge. Dr Reason can filter some of the confusion but, contrary to what we all desire, medicine is not a completely predictable science or a tidy puzzle where all the pieces snap neatly into place. Most of the day Dr. Reason is muddling along, awed by the knowledge that the small pond of what we know is dwarfed by the ocean of the unknown.

Each personality of Dr R³ can be eccentric and can get kind of “out there,” so they'll apologize for one another in advance. You must know that one of them at times might not get all the facts right, be edited for space, political correctness or simplification. They will work at documenting some of their sources. Listening to these three chatter and bicker, however, might make you a more sophisticated consumer. Dr Rant proclaims his first amendment rights to free speech while warning the reader in advance, “Consumer beware. Anyone following Drs' Rave or Reasons advice deserves what they get!” Dr Rave's position is, “Taking advice from a column is not a substitute for consulting your physician. Nothing construed here should be mistaken for diagnosing or treating any medical condition.” Dr Reason's parting comment is, “Our esoteric banter is meant to be educational, so enjoy it for what it is, entertainment.”

Dr R³ already know in advance that even when the facts are right, many people will find objections or disagree. After all, the multiple-personality disagreements raging inside them is just a microcosm of society's conflicting beliefs and experiences about health care. Welcome to your own brand of schizophrenia and the chaos of the medical system.

- Alan Dappen M.D.

NEXT ISSUE: Doctors Rant, Rave, and Reason tackle back pain