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Monday 8:30am - 5:30pm Tuesday 8:30am - 5:30pm Wednesday 8:30am - 5:30am Thursday 8:30am - 5:30pm Friday 8:30am - 5:30pm

Santa Monica Primary Care

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Santa Monica Primary Care

Santa Monica Primary Care is an independent, full service Internal Medicine practice located in Santa Monica, CA. Dr. Philip M.

Santa Monica Primary Care is an independent, full service Internal Medicine practice located adjacent to Providence Saint John’s Health Center in Santa Monica, California. Bretsky first established the practice in 2008 in Century City, California. Following two years in Century City, he moved to Santa Monica in 2010 and the practice was renamed Santa Monica Primary Care. Our office provides both outpatient and inpatient healthcare for patients. Dr. Bretsky is on staff at two local hospitals: Providence Saint John’s Health Center, and Cedars Sinai Medical Center. He also takes care of patients at nearby Skilled Nursing centers such as Berkeley East, Seaport 17, Rehabilitation Centre of Santa Monica and Santa Monica Healthcare. If needed, this enables Dr. Bretsky to maintain continuity of care for patients from the office, to the hospital, to the rehab center, and back home. Our office is staffed with carefully selected and highly trained people who do their best to provide you with a friendly, positive experience in our office. Leading the team is Marian Henry, who brings over 20 years of business and management experience across many fields to deliver a standard of administrative excellence to our office. Santa Monica Primary Care provides a comprehensive range of services that help our patients maintain their overall health. We offer our patients annual wellness exams, acute and chronic illness management, preventive and diagnostic skin procedures, cardiac stress testing, in-office ultrasounds, sports physicals, travel medicine, and vaccines. We believe that patients should be able to center their care around our office, which is why we offer extensive services in-house. This allows our patients more time to spend enjoying their health outside of a doctor’s office and more time with their friends and family.

09/16/2025

COVID infections show a seasonal pattern with two clear peaks: the largest during the winter months (November–January) and a smaller one in mid-to-late summer (July–August).

This is why vaccine guidelines recommend that patients at highest risk for severe illness receive a COVID booster in both the Spring and Fall of each year.

Here at Santa Monica Primary Care, we’ve once again seen an August uptick in cases compared to the Spring and early Summer. Looking back over the past three years (2023, 2024, and 2025), the sharp rise in July and August is consistently seen.

Historically, we can expect a brief reprieve in early Fall, followed by the expected Winter rise—similar to other respiratory viruses such as RSV and Influenza.

We cover this seasonal pattern in more detail in our September newsletter:

👉 https://drbretsky.com/september-2025-newsletter/

09/12/2025

Respiratory Syncytial Virus (RSV) historically has been a major cause of bronchitis and pneumonia in infants and young children. With improved RSV testing (we have rapid antigen testing for RSV in our office) and an aging US population, we now recognize that it is a major cause of hospitalization in older adults as well.

In the United States, a single dose of RSV (Arevxy, mResvia or Abrysvo) is recommended for all adults over the age of 75 as well as those 50-74 if at increased risk (heart/lung disease, immunocompromise, or living in a nursing home). Similar guidelines can be found in the UK and Australian vaccine recommendations.

One of the more interesting features of its epidemiology is the consistent pattern of infection and disease. Whereas other respiratory viruses cause epidemics at irregular intervals or exhibit a mixed epidemic/endemic pattern, RSV produces a sizable epidemic every year in large urban centers. These typically occur in the last fall, winter or spring but never during the summer.

There is no revaccination recommended as yet. Ideally the RSV vaccine should be given late summer to early fall (August to October) before the RSV season starts.

We cover RSV vaccine recommendations and its epidemiology in more detail as part of our September newsletter.

Newsletter Link: https://drbretsky.com/september-2025-newsletter/

09/11/2025

Unlike the current debate surrounding Fall 2025 COVID-19 boosters, recommendations for a 2025/2026 seasonal influenza vaccine remain unchanged.

In the United States, everyone over the age of 6 months is recommended to have a flu shot. Both the UK and Australia have essentially the same guidance.

Interestingly, the UK prioritizes pregnant women such that their vaccination window begins September 1st, with the remainder of the population eligible beginning October 1st.

For Australia, the vaccination window is March and April due to their location in the Southern Hemisphere. The WHO GISRS system (Global Influenza Surveillance and Response System) uses Southern Hemisphere data to inform Northern Hemisphere vaccine formulation (and vice versa).

We cover seasonal influenza recommendations in our September newsletter.

Newsletter Link: https://drbretsky.com/september-2025-newsletter/

09/08/2025

Our September 2025 newsletter edition is entirely devoted to the 2025/2026 seasonal vaccines - specifically COVID, Influenza and RSV.

Newsletter Link: https://drbretsky.com/september-2025-newsletter/

In it, we review some of the historical decisions in US Healthcare (moving vaccinations from the physician's office to pharmacies) as well as recent events (the disbanding of ACIP) that immensely complicate this season's vaccination efforts.

We have little expectation for the current administration to provide meaningful vaccine guidance for at least the next three years. As such, we also review COVID booster recommendations (detailed in the table below) from the UK and Australia.

08/08/2025

In the Bretsky Blog post today ( https://drbretsky.com/bretsky-blog-8-august-2025-on-colore**al-cancer-crc-screening/), we cover the ‘biggest non-COVID news of COVID”, that being the US Preventive Task Force recommendation of lowering the age of colon and re**al cancer screening from 50 years to 45 years.

In a research letter published in this week’s Journal of the American Medical Association (link: https://jamanetwork.com/journals/jama/article-abstract/2837231) it appears that this 2021 recommendation led to significant increase in screening amongst younger individuals. Further, an accompanying article (link: https://jamanetwork.com/journals/jama/article-abstract/2837232) details a significant increase in the detection of early-stage CRC tumors among those 45-49 years of age.

As with most cancers, CRC caught early has far better survival (90.9% 5 year survival for localized disease) as compared to regional spread (73% 5 year survival) or distant metastasis (13-18% 5 year survival).

**al

08/07/2025

In today's Bretsky Blog, we cover the termination of 22 Biomedical Advanced Research and Development Authority (BARDA)-backed mRNA vaccine development projects, totaling nearly $500 million in funding.

“We reviewed the science, listened to the experts, and acted,” said HHS Secretary Robert F. Kennedy, Jr.

In actuality, he just acted. We cover the misinformation and his fundamental lack of understanding of viral mutation and evolution.

Link: https://drbretsky.com/bretsky-blog-7-august-2025-on-rfks-unilateral-cancellation-of-barda/

08/04/2025

Returning in August is Dr. Bretsky's Blog. Today's post covers the CDC's new Director, Dr. Susan Monarez - confirmed last week by the Senate.

In what is an unlikely coincidence (given Dr. Monarez's expertise in infectious disease immunology and diagnostics) the CDC on August 1st released an alert highlighting falling vaccine rates amongst US kindergarteners.

Our blog post covers the implications of such, covering MMR (measles, mumps, rubella) and DTaP (diphtheria, tetanus and acellular pertussis) in particular.

Blog Link: https://drbretsky.com/bretsky-blog-4-august-2025/

03/27/2025

Earlier this week I had the opportunity to be a judge at USC Keck School of Medicine's annual Medical Student Research Forum and Poster Day. There was an incredible array of student-driven research. It was a joy to return to the campus where I had spent 8 years (!) of my medical/ scientific training.

It did bring to the forefront the massive NIH cuts that the Trump Administration has implemented and just how these will differentially impact young physician/scientists.

Without exception, every poster I reviewed was a multi-disciplinary and multi-institutional effort. One presenter was working with researchers n Denmark, another with faculty at the University of Oklahoma. These opportunities don't just arise out of thin air, they take years to cultivate and aren't captured in direct NIH funding. So to implement an across-the-boards 15% cap alone is demonstrative of how little the current NIH leadership understands about medical research.

The combination of reduced indirect cost reimbursements and departmental restructuring presents a huge roadblock to biomedical progress with young physician/scientists differentially impacts. To compound it, that's where the best new ideas come from, these young investigators.

03/14/2025

In contrast to our earlier post ("Where did COVID infections go?"), influenza cases have been as frequent and severe in any year I have seen in my nearly 20 years of clinical practice.

By late February, there had been over 480,000 hospitalizations and 21,000 flu-related deaths in the US. This season H1N1 and H3N2 have been the predominant strains reported; the H3N2 strain has been associated with more severe illness.

This season’s vaccine targets H1N1 and H3N2 so should be a good match against the predominant circulating strains. In fact, preliminary data from the CDC suggests vaccine efficacy ranging from 42%-72% in the outpatient setting and from 39% to 53% against hospitalization.

As expected given CDC and HHS leadership's hesitant vaccine stance, flu vaccination rates have declined compared to previous years . Typically in the United States about 50% of adults get the annual flu shot. Concerningly, a recent survey indicated that only 38% of US adults intended to get the flu shot in 2024/2025.

The graph below from the CDC shows the rapid rise in flu hospitalizations beginning mid-December 2024, with only the 2014/2015 and 2017/2018 seasons as close comparisons in scope and severity.

More can be found in our March newsletter: https://drbretsky.com/march-2025-newsletter/

03/13/2025

More from our March 2025 Newsletter (available at: https://drbretsky.com/march-2025-newsletter/)

We reviewed RFK's tepid and inaccurate response to the widening Texas measles outbreak.

In 1948, virologist Kenneth Maxcy wrote “the simplest of all infectious diseases is measles.” It is entirely dependent on the habits of humans and has an unusually high infectivity.

RFK’s discussion of good nutrition as a “best defense” reveals his inexperience in interpreting clinical studies. While mortality associated with measles is highest where malnutrition is prevalent, it is not possible to separate the effects of malnutrition from the direct effect measles exerts by decreasing appetite and food assimilation.

His discussion of Vitamin A is also confounded. Vitamin A treatment of children with measles is recommended in areas where Vitamin A deficiency is endemic. However, the only study performed in resource-rich setting did not show a benefit to Vitamin A administration. The analysis of six Vitamin A treatment randomized controlled trials found no significant reduction in measles mortality.

The widespread use of the measles vaccine post-1963 led to a dramatic decrease in measles cases, underscoring the vaccine’s critical role in controlling and preventing the disease.

03/12/2025

More from our March 2025 Newsletter (available at: https://drbretsky.com/march-2025-newsletter/)

Where did COVID infections go?

COVID-19 cases in 2025 have been unexpectedly low this Winter season both in LA County as a whole and in our neck of the woods in Santa Monica. We did experience a significant late summer surge in 2024 but we typically see a seasonal rise in COVID cases beginning after Thanksgiving (Figure 1).

However, for Winter 2024/2025, that surge never materialized and case rates remained low.

Cases for the week of January 12th 2025 barely register on the graph when compared to prior years. Looking at them numerically, there is no comparison:

2025: 1.50 new daily cases per 100,000 population
2024: 7.23
2023: 15.86
2022: 465.46
2021: 142.00
2020: n/a (no reported cases until March 2020 in Los Angeles County)

Within our practice at Santa Monica Primary Care we have also seen a far lower incidence of COVID cases in the months of January and February as compared to years prior (second figure).

03/11/2025

Our March 2025 newsletter is now published on our website at: https://drbretsky.com/march-2025-newsletter/

One topic we cover are the ongoing health threats in the aftermath of the Palisades and Eaton Fires. These include respiratory concerns from ash and particulate matter as well as water safety (both ingestion and exposure while swimming / surfing). Waterborne exposure at local beaches is particularly timely as another storm now gathers across Los Angeles.

The first picture illustrates just how just how insidious the fine particulate matter from the fires can be, showing how ash worked its way into the charge port of my car.

The second picture shows coagulated debris at the tide line at the beach in Santa Monica. This represents ash and debris runoff from the Palisades Fire.

You can sign up for our newsletter at: https://lp.constantcontactpages.com/su/JtF9zzR

Address

1301 20th Street, Ste 230
Santa Monica, CA
90404

Opening Hours

Monday	8:30am - 5:30pm
Tuesday	8:30am - 5:30pm
Wednesday	8:30am - 5:30am
Thursday	8:30am - 5:30pm
Friday	8:30am - 5:30pm

Website

http://drbretsky.com/

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Our Story

Santa Monica Primary Care is an independent, full service Internal Medicine practice located adjacent to Providence Saint John’s Health Center in Santa Monica, California. Dr. Philip M. Bretsky first established the practice in 2008 in Century City, California. Following two years in Century City, he moved to Santa Monica in 2010 and the practice was renamed Santa Monica Primary Care. Our office provides both outpatient and inpatient healthcare for patients. Dr. Bretsky is on staff at two local hospitals: Providence Saint John’s Health Center, and Cedars Sinai Medical Center. He also takes care of patients at nearby Skilled Nursing centers such as Berkeley East, Seaport 17, Rehabilitation Centre of Santa Monica and Santa Monica Healthcare. If needed, this enables Dr. Bretsky to maintain continuity of care for patients from the office, to the hospital, to the rehab center, and back home. Our office is staffed with carefully selected and highly trained people who do their best to provide you with a friendly, positive experience in our office. Leading the team is Marian Henry, who brings over 20 years of business and management experience across many fields to deliver a standard of administrative excellence to our office. Santa Monica Primary Care provides a comprehensive range of services that help our patients maintain their overall health. We offer our patients annual wellness exams, acute and chronic illness management, preventive and diagnostic skin procedures, cardiac stress testing, in-office ultrasounds, sports physicals, travel medicine, and vaccines. We believe that patients should be able to center their care around our office, which is why we offer extensive services in-house. This allows our patients more time to spend enjoying their health outside of a doctor’s office and more time with their friends and family.