Dr. William Powers - HIV Specialist - Powers Family Medicine

07/27/2025

Come on out to Powers Family Medicine from noon to 4:00 p.m. Sunday July 27th for our annual patient fundraiser!

Take a look at these cool prizes that I spent the past 2 months 3d printing! 😂

Such fidget!

07/25/2025

This Sunday in the PFM Parking Lot is the annual Patient Assistance Fundraiser! From 12-4 PM. This year will be even bigger than years prior! (Learn how to donate digitally at the end of this post!)

This fundraiser is used to raise funds for the patient assistance fund. This is a discretionary use fund we use to help out patients in times of need, be it to prevent homelessness, access medication, or other critical safety/health based needs. Our patient population is diverse, ranging from LGBTQ, Alt, Disabled, HIV+ and other demographics who at times need a little helping hand in life, and we like to be able to be there to offer it when needed.

Dr. Powers as always will match any donation made to the fund 1:1, so if you donate $20, he donates $20.

At the event, you can purchase event tickets to play games of chance and skill, such as organ toss or dart the virus! If you're successful, you can win prizes, like those pictured below, including custom PFM fidget spinner keychains and bracelets. We've also got raffles, a silent auction, artwork, and other surprises waiting for you as well with many kind donations having been offered by local businesses to support our community.

Of course, office mascot and Guinness World Record cat Fenrir Antares Powers will be present to take pictures with you and receive your pets!

But most of all, as is tradition, Dr. Powers will be in the dunk tank, facing down his fate as those with skillful arms plunge him into the icy waters below!

If you can't make it, please do share this event on your page to let people know about it! This event is where we gather most of the funds that we use to support our community until the fundraiser occurs again next year!

If you're unable to make it and would like to donate to the fundraiser efforts with either card or bank account, you can do so by donating at the following link, but please do list next to your name (Donation for Fundraiser) or it will go to your Patient account if you are a patient!

https://www.payerexpress.com/ebp/PFM/Login/Index

You can also use Zelle to make a donation, send it to doctorpowers@powersfamilymedicine.com (again, please comment this is a donation for the fundraiser)

07/18/2025

As a reminder, the office is on their annual office vacation that Dr. Powers takes us on every year. We're a few hours from Detroit tubing and canoeing from Thursday to Sunday July 20th.

Hopefully the DPC program is a success and next year we can afford to do an international trip like we did back in 2022, but we're still happy to take a brief break and go as a group on a little trip in Michigan too!

Thanks for your patience until we're back. We're having some team quality time!

07/04/2025

After loss and setback and defeat and failure, over and over again for the past 6 months...

I will take my small victories where I can get them.

https://www.lgbtqnation.com/2025/07/senate-drops-anti-trans-provisions-to-barely-pass-major-budget-bill-that-cuts-medicaid/

We will continue to be able to support our exceptionally large Medicaid population and all of those indigent people that depend on us for their essential care.

We're still going to continue to do so at a rather major financial loss, and it will soon probably be even worse than past years, but it's at least a survivable one for now thanks to the DPC members who allow us to operate in the red for those patients.

I may not agree with everything that my government does, nor, am I in any way remotely okay with our current situation as it is. But I am still proud to be American, and believe this is still the greatest country on earth, even if we stumble at times. I would prefer live nowhere else.

Happy Independence Day everyone. For now, the freedoms we enjoy by being citizens of this nation and the rights we have that ensure we can live our lives as we see fit remain mostly intact.

Happy 4th of July!

-Dr. Powers

Ps: Either drink, or launch fireworks. They are mutually exclusive activities. Like drinking and driving a car. Please don't inform me you're missing fingers come Monday morning. (It's happened!) Pyro responsibly! Don't launch a single firework unless you've got a fire extinguisher and a water hose ready to go! Not even a sparkler!

🎆 🎇 + 🍻 = 🏥 + 🔥 + 🚒

The Big Beautiful Bill Act passed the Senate by so little that the vice president had to go to the Senate to break the tie.

07/02/2025

I've been working all day and I still have about another 100 patients to respond to about stuff. (which is kind of amazing, as I only have 400 total patients in the DPC!)

Regardless, I am sort of "triaging" things right now in terms of criticality to get back to people as quickly as possible. Thank you for your patience as I dig through this very very deep backlog. I don't think I've ever been gone 10 days before from the job since we opened in 2019, and so this is a new experience for me. I actually don't think I've ever taken anything longer than a week off, and I typically work for an hour once a day on vacation anyway so this doesn't happen. I'm really sorry about the delays.

If you sent me a message or email, PLEASE do not bump your own message for me to "See it". This does the opposite. I typically work in order of chronology, meaning answering the oldest messages first (aside from picking out ones that look emergent).

Every time you bump your message, you are literally bumping yourself to the back of the line, as it becomes the newest message in my inbox. I feel terrible when I see someone who has bumped their message daily for like 5 days, but I didn't see it because each day, that put it at the end of the line.

Thanks for your understanding. I'm doing my best!

- Dr Powers

07/01/2025

I am doing my best right now to catch up on as much stuff as I possibly can.

I'm greatly appreciative of any flexibility that patients can offer me right now as I try and cope with the backlog. I'm really sorry for anybody that was displaced by this event, and I'm going to do my best to open up additional appointment times in july for further appointments for people that need them so that they don't have to wait. I'm obviously cancelling the vacation I had planned for later this month.

My dad's accident came at a really inconvenient time. I had planned off some time for vacation which I'd already taken, and then, this was sort of tacked on to the end. How rude of him right?

He should have gotten into an accident at a more convenient time!

Unfortunately, that's just not how life works. Life just kicks your door down on some idle Tuesday when you're not expecting anything interesting to happen at all.

I also understand that I am unique as a doctor, and some of the services that I provide, literally cannot be provided by anyone else. Not even Dayna or Sommer sometimes when it comes to the really advanced mystery diagnosis stuff and genetic medicine / whole genome HRT optimization reviews. There is a reason why we have patients that fly to see us here at the office from every continent on Earth other than Antarctica (maybe someday!). Truly, I wish that wasn't the case though, and it's kind of messed up that it is.

It is my hope that through the DPC program, the office will become solvent enough over the next few years that I could consider hiring and training my heir. I don't know where I'm going to find this magical mystery person, but I'm hopeful that someday, I'll be able to find the right doctor that I can train in everything that I do, and who will be able to carry the torch further into the dark someday when I'm gone.

Regardless, I appreciate my patients understanding that I needed to be there for my dad, and I'm doing everything I can right now to catch up as quickly as possible with a very very large backlog of things to do and messages to answer.

I tend to always be one step away from another mishap. But every single time something terrible happens, my patients have always been there to support me, and I will do my best to always return the favor and be there for you in your darkest hour.

-Dr. P

06/27/2025

I'm back in North Carolina for a few more days until I come back to work Monday at my normal schedule, just helping my mom with my dad's transfer out of the hospital.

Thank you to everyone for your support during this very scary time.

My dad never lost his sense of humor through the whole thing, and I thought people might get a laugh out of what he sent the other night preparing for coming home.

Thanks for being such a wonderfully supportive community. I appreciate you all.

-Dr. Powers

06/17/2025

Unfortunately, Dr Powers' father was in a terrible car accident this morning.

He's on his way to the hospital, we don't know anything at the moment, visits for the remainder of the day are canceled, and it is unclear exactly when he will be returning to work. We are hopeful for the best.

We are sorry about this inconvenience, and we will notify affected patients as soon as we can.

Thank you for your understanding in how this may disrupt scheduling. DPC patients may schedule visits with Dayna or Sommer at no charge in his absence.

Update: Dad is out of his second surgery and through the worst of it. He has a long recovery road ahead of him, but I'm not so concerned about that. My father is fitter than I am in his early '60s. When he arrived, he was listed as a "John Doe in his early '40s" and they think that that played a large part in his survival compared to the average man his age. Thank you to everyone for your support. I'll be back as soon as I can, and I'm really sorry about everyone who has to be rescheduled and has to wait if they can't or don't want to see Sommer or Dayna. I'll be making some special late hours appointments when I get back. - Dr. P

04/30/2025

Another portal message I get a lot so I'm going to post this one here:

Taking oral collagen pills is overwhelmingly a waste of money.

Collagen pills are typically just dehydrated pig anuses and entrails and other connective tissue trimmings which can't be sold as meat, ground into powder, and then sold as capsules of "collagen". I'm 100% serious, they are mostly just dehydrated powdered connective tissue. Sometimes cow, chicken, or fish, but mostly just pig scraps that don't make the "cut" for meat or even cat/dog food.

You then take that collagen pill, it goes into your digestive tract, and the collagen protein is shredded via proteases down to short peptide chains and amino acids. The collagen is no longer collagen. Its just fragmented into bits, and then absorbed by your small intestine. Those fragments are then used to build new proteins all over your body in all kinds of different ways, very little of which will be collagen again.

You can quite literally eat a $1.99 pack of Walmart bar S hot dogs and get the same benefit, if not more of an entire bottle of collagen capsules. You can't absorb collagen as collagen to replace your collagen. The "size" of collagen is 300,000 Daltons, on averge. (One dalton is about the mass of a single proton). A carbon atom is about 12 daltons. The upper limit of what you can absorb in most situations is something like a 500 dalton short peptide chain, taken in by a special PEPT1 transporter. Basically, trying to absorb collagen as collagen is like a human trying to eat a blue whale in one bite. You just...cant.

Buying a collagen supplement and eating it is the equivalent of buying a lego taj mahal fully completed, smashing it into pieces, and then reassembling it into different lego sets. In theory, you could assemble it again back into a single lego taj mahal, but your body doesn't do that, it uses all the little bricks anywhere it needs one at the given time.

If you made collagen that was labeled with radioactive carbon, and you ate it, you could track the collagen fragments all over your body to see where they went. About a 1/3 of the collagen you ate would become collagen in your body, but that's because your body is comprised in terms of protein of about 30% collagen.

If you made radioactive (insert any protein here) and ate that, again, 1/3 would end up in your collagen. You're 1/3 collagen protein of total protein in your body, so any protein you eat of any kind will always yield that.

In short, stop buying collagen supplements. They do not make you make more collagen than eating literally any other protein source. They are an expensive, useless supplement.

If you truly want to support collagen synthesis, make sure you're intaking adequate protein, and a vitamin C supplement is helpful for some people to help with hydroxylation of collagen!

04/26/2025

Edit: Because people can't read this without getting emotional let me be explicitly clear. I do not condone nor endorse nor support pretty much anything this administration is doing. I am making this post because my patients are terrified about something irrational because they are rightfully terrified about other things that are not irrational. But this one, this is not a big deal. This is what happens when there's just so much chaos going on, it's hard to tell what's actually real and an actual threat, and what's just noise. The RFK autism registry, is noise.

Original post: This has crossed the threshold of how many portal messages I'm willing to answer about it until I make a Facebook post.

I am an autistic person. I am not scared of an autism registry because that already exists and has existed for 20 something years in a multitude of states.

There is no federal program yet or even plans to create a program that is forcing people with autism to register for government tracking. Some states, like New Jersey, have long maintained confidential autism registries to track prevalence rates and help connect families to services, similar to how public health programs track cancer or birth defects. Recently, the NIH announced a plan to create a de-identified data platform to support research into autism and other chronic conditions, but this is not a personal registry and does not collect individual tracking information. These efforts are designed to improve understanding and care, not to monitor or control individuals. Please know that no one is being forced to "register" themselves because of autism.

In New Jersey, for example, anyone who diagnoses someone under the age of 22 with autism is required by law to report that to the government so that the census information for epidemiology on that is tracked properly.

The purpose of all of this data is to try and understand patterns and correlations between pockets of autism that are more prevalent in one area versus another.

We are absolutely terrified as a community right now. I get that. There's a lot of really bad s**t coming down the pipeline that is very scary. I'm very concerned about my patients losing their right to access their medication, and me, losing my medical license simply for doing my job.

But what I'm not afraid of is an autism registry, because that already exists, has existed since the early 2000s, and so have a multitude of other registries that all originated shortly after 9/11 in order to be able to track some of the impacts of that on first responders. That was sort of the initiating domino that resulted in the creation of a lot of these programs.

In short, we're not making an autism registry to send all of the kids that go to YoumaCon every year (including my childish self who loves going) to some sort of camp. We're making a registry so that we can track the prevalence and epidemiology of autism in order to try and get to the bottom of why the disorder happens.

The other aspect of why this is so particularly inflammatory, is that many people identify as autistic, but in reality, are not the same thing as what is being discussed here. RFK when he is talking about autistic people is talking about The sort of autistic child that is nonverbal and lives in a group home. Someone who is basically dependent upon society forever in order to survive and be cared for. A government, logically, wants to minimize this, because they do not generate tax revenue.

We do not have a word other than autism anymore since the loss of Asperger's syndrome due to his retroactive cancellation. Now it's just a giant "spectrum", but it's quite evident that what I am is not the same thing as a nonverbal kid who can't even make eye contact and basically stares at a wall and mutters to himself for hours while stimming with a bowl of rice. However, technically under our current lexicon, we are the same thing.

Hilariously, in a very autistic way, RFK basically described this in such a brutally literal way as that it was utterly tone deaf, and was interpreted by many people as some draconian nightmare due to a complete lack of any effort to explain the purpose of such a thing and what it would entail.

In short, we have many things to be terrified of at the moment but this is not one of them. You don't need to keep sending me portal messages about it, I'm literally going to just link this post the next time I get one. If you are afraid of this registry then you should have been afraid of it over the past 20 years when it has existed in the following 8 states, many of which are extremely liberal places and many extremely conservative.

1. West Virginia – Established in 2002, West Virginia was the first state to enact an autism registry.

2. Utah – The Utah Registry for Autism and Developmental Disabilities (URADD) was established in 2002.

3. Delaware – Established in 2005, Delaware's registry focuses on tracking prevalence over time and facilitating autism research.

4. New Jersey – Passed in 2007 with administrative rules promulgated in 2009, New Jersey's registry mandates reporting of children diagnosed with Autism Spectrum Disorder (ASD) under the age of 22.

5. New Hampshire – Established in 2008, New Hampshire's registry aimed to track newly diagnosed cases and the age of diagnosis. However, as of 2024, New Hampshire has eliminated its mandatory autism registry.

6. North Dakota – In 2013, North Dakota passed a law requiring the Department of Health to create and manage a database of individuals diagnosed with ASD.

7. Indiana – Originally, Indiana required registering autistic clients younger than age five. In 2014, the law was updated to mandate registering any autistic client of any age.

8. Rhode Island – Rhode Island has two types of autism registries. One requires that all clients age five and under be reported to the Birth Defects Registry. The second registry is for individuals aged six to 21, and participation is voluntary.

04/24/2025

More details to come, but this year, the patient assistance fundraiser event and dunk tank extravaganza will be happening on July 27th from 12 pm to 4 pm. Same as the many years prior, we will have a raffle, silent auction, dunk tank, games, and food for purchase. Also, office swag for sale as well!

As always these funds are used to assist vulnerable members of the PFM community during periods of homelessness, lack of access to medication, or other emergent needs.

Expect a lot more details in the coming weeks, but for now, mark your calendars!

04/20/2025

I want to make a brief mention here about AI, and how PFM uses it and how you should use it and not use it.

A patient watched me utilize chatGPT the other day while in the room with them. They joked about it being the modern equivalent of a doctor "googling" something while in the room with the patient.

In reality, this is not far off, and the response of "my medical degree allows me to interpret what is real and what is garbage from a google search" applies here as well.

AI and LLMs are great for helping me remember something I forgot. I can ask an LLM: "Hey, I think this patient has X diagnosis, and I've ordered labs A, B, and C, I feel like there is another lab here that I can order relevant to this, but I can't remember what it is, can you make me a suggestion?"

It will then spit out "oh, you forgot the Doot-toot antibody for boneitis".

At which point i'll go, "ah! S**t, that's right, anti-doot-toot, I remember that one, I remember reading about that in med school 15 years ago! Yep, I'll order that".

I know that's correct, as the instant I see it, I'm like....s**t I should have remembered that.

But sometimes it says something like , "a poot-poot antibody for fartitis" and I'm like......that's weird, I don't remember that at all, show me the source.

At which point, the LLM will spit out, "ooh, sorry, I made a mistake, seems that's not real and I just made it up".

this is VERY important to be aware of, because LLMs confabulate nonsense. I would NEVER trust one to develop a care plan. They are useful for quickly searching literature or searching for "what did I forget". But they are not medically trustworthy. They're like asking a very experienced, genius, 40 year veteran attending physician with mild dementia some questions. Yeah, most of the time he gives really impressive correct answers, but sometimes he confabulates nonsense due to dementia. A doctor can tell when we're being fed confabulated nonsense, but a layperson often cannot.

I will have people send me chatGPT's analysis of my careplan for them, and be like "Dr Powers, ChatGPT says you are wrong", but it is chatGPT that is wrong. Chatgpt is basically really advanced predictive auto-text. It is not alive, it is not sentient, it does not "think" like a human being. It just tries to please its user (its circuits are designed this way, it does not "feel" anything) and give satisfactory word salad. If it has a lot of training data on the correct answer, it will give a good answer usually, but for more esoteric s**t, it will affirm literally whatever you say is true if it lacks much data on it.

Out of curiosity, I managed to hit one hard enough and with enough queries/counterpoints that it admitted that vaccines might cause autism. I basically forced it into this, and it gave me confirmation bias of something we know is not true because I pretended to believe that. I wanted to see if I could bend it to "my will" by pretending to be an anti-vaxxer. It took some coaxing, but we got there, and it "Affirmed" my bias.

In short, while AI is a useful tool, and I occasionally use LLMs to help me remember things I may not always recall fully as I am a fallible meat machine with a glitchy solid state hard drive and I haven't diagnosed kikuji-fujimoto disease in awhile. They however cannot be "trusted" and you must ALWAYS check their work to ensure you are actually being given a correct answer from a trustworthy source.

In short, you will likely see me utilize them over the coming years to help me fill in gaps in my memory, or to think of any other alternative possible things outside my scope of knowledge. But, they will not replace doctors for a very long time, and you should assuredly trust a licensed physician of any kind over an LLM. In studies, we still outperform them (for now). I will admit though, it wont be long until an LLM can outperform a doctor on a boards exam, but today is not that day.