Premier Internal Medicine and Pediatrics

10/16/2025

Hey everyone, I wanted to clarify something that is causing some confusion. It is very much true that I've gotten into professional photography and started a business named GraceAlise Photography. However, I AM NOT CLOSING MY CLINIC TO DO PHOTOGRAPHY FULL TIME!!!!!!!!! My photography is on Saturdays and some Sundays when my office has and will always be closed. I have always done photography, dating back to my college days, and decided that my mid-life crisis would manifest as doing professional photography instead of buying a motorcycle or getting hair implants. There has never been a day in the past 8+ years that I've dreaded coming to my office and doing the work that I do. I LOVE my patients and I LOVE my employees. I remain 100% committed to Premier Internal Medicine and Pediatrics, my employees, and especially my patients, until God says my assignment is done. So ya'll...please chill!!!! I just wanted to start a side hustle career that allows me to have a creative outlet. That said...I am on all the socials at GraceAlise Photography by Keith Perkins.

10/14/2025

Good morning. This is a blog I've been wanting to put out for years, and I finally got around to do it. If you have any questions, feel free to DM me.

Decisions, Decisions

06/27/2025

https://open.substack.com/pub/soloprimarycaredoc/p/hypertension?r=5h4wb1&utm_medium=ios

Silent until it becomes deadly

04/17/2025

https://open.substack.com/pub/soloprimarycaredoc/p/fibromyalgia?r=5h4wb1&utm_medium=ios

Fibromyalgia is prevalent and affects about 2% of Americans.

04/09/2025

https://soloprimarycaredoc.substack.com/p/infant-reflux?r=5h4wb1

Very common, rarely dangerous

05/26/2023

Good evening. I was just informed of a new Tennessee state law that might affect some of you. Many family members bring children in for well child visits and vaccines when their parents are unable to. Unfortunately, although they can continue to bring the them in for sick and well child visits, only the parents and legal guardians are allowed to accompany children when they receive vaccines. This means that grandparents, aunts, uncles, and even siblings are not allowed under any circumstances to bring your child in if they are receiving vaccinations. Failure of any pediatrician to do so will result in them losing their license and will essentially end their career.

To stay in compliance with the law, if your child is coming in to receive vaccines every parent needs to bring a copy of their child(ren) birth certificate so that we know you are the true parent. Legal guardians must provide a legal court ordered documentation. If we don’t have those documents they will not receive vaccines. There will no exceptions because I’m not risking my career. I can assure you no one else in the state will. Once we have them, you never have to bring them again because those documents will be in their chart. People who know me know how I feel but I don’t individually have the power to change it and I’m not quiet ready to retire.

04/13/2023

As we all know, there have been major issues with pharmacy shortages of ADHD medications. Because of this, we have been inundated with phone calls asking us to send prescriptions to multiple pharmacies hoping that that pharmacy will have it. Others have been demanding we call pharmacies to see if they have the medication available which is something that we aren’t ever going to do. Starting this week, I will be printing all prescriptions for ADHD medications to be picked up at my office until further notice. I am well aware that this will be an inconvenience for those that I am treating but the amount of phone calls we are getting is out of hand. Having a script in hand will allow you to take it anywhere that has the medication available. We hope the shortage resolves soon and I can go back to eprescribing those meds again.

04/14/2022

Good morning. I hope everyone is safe!! Unfortunately we will be closed today due to a lack of internet service and hot spots!! I hate it but there is nothing I can do. We will be back open on Monday Lord willing. For those who we don’t call to reschedule I apologize. I don’t have access to the schedule. If you need refills please have your pharmacy send us a request. Please spread.

03/08/2021

I wanted to announce that we have the Moderna Covid vaccines available for anyone who wants one. Qualifications according to the state of Tennesse is anyone who has chronic health problems over the age of 16 or if you are exposing someone who has a chronic health problem, however we often have doses left over and we do not want to waste any. Because we have a 6-hour window to give 10 vaccines per opened vial, for now, we are scheduling appointments only between 10am and 4 pm but on Thursdays we will have them available between 11 am and 5pm. You DO NOT have to have insurance and you DO NOT need to be patients of ours. We simply ask that you do not walk in. We are located at 714 Federal Drive in Selmer, TN.

Call our office at 731-540-9083 or book online through our website if you want one.

02/14/2021

Good morning. Due to the impending bad weather, our office will be physically closed Monday, February, 15th and possibly Tuesday, February 16th. I will, however be available for virtual/telemedicine visits via our Klara app both days. Klara is available on our website www.premiermedpeds.com. A box should pop up saying “send us a message” in a purple box if you are using a computer browser. I will attach a picture of the purple icon if you are using a phone browser. For those who are familiar with Klara you already know how it works.

As a reminder, virtual visits ARE NOT free so copays and deductibles still apply if your insurance plan requires such. Be safe!!!!

01/14/2021

Hello all. This post is very much overdue and it's a long post.

First off, thank you all who have encouraged and prayed for not only my safety and health but that of my staff.

TESTING:
There is a lot confusion about when to test. For our rapid machine to pick up the virus at the 95.7% accuracy rate and for that matter, almost all the rapid machines the clinics are using, you need to be at least 5 days past your exposure to a confirmed positive individual if you have no symptoms. It can be sooner if you have symptoms but even then, there are other things like the allergies, flu, and rhinovirus that could give you similar symptoms before COVID kicks in. I don't send out a confirmation (PCR) unless I still think you have it or your job requires it. I will not refuse testing to an individual who just got exposed "yesterday" but I also warn them that it is likely falsely negative because the virus hasn't had time to grow.

TESTING INFANTS AND TODDLERS:
Although I'm not going to argue with any parent that absolutely wants their baby tested, my rule is that if the caregiver has it, assume the baby or toddler has it. They can't self quarantine from you and they don't work. In addition, they rarely show symptoms and if they do, they are mild symptoms such as congestion and maybe a cough. If they are in daycare, that's a different story, but if they stay home, there is no need to shove a q-tip up their noses for COVID.

QUARANTINE RULES:
I'm gonna keep it simple. Ask your kid's school or your job. Everyone is creating their own rules outside of expert guidance so I have no clue what to tell you. So....that's that.

HOW LONG ARE IMMUNE IF YOU'VE HAD IT:
At least 6 months.

COVID VACCINE:
As of today, I have signed up with the State of TN to be a COVID vaccine provider. I don't know if or when we will receive a shipment for distribution.

I will tell you that I have gotten my first COVID shot and outside of a sore arm I was fine. That was simply my experience and it may not be yours. I'm not on here to compel anyone to get it and I'm much too old to fight people on social media. But I'm sick of wearing masks, I'm sick of calling love ones to tell them their father, mother, or child died a horrible death alone and hearing their screams of sorrow (I work as a hospitalist too if case you were wondering), and I'm tired of not being able to see my parents. Although I'm glad I have been able to provide COVID testing since March, I'm tired of seeing buggers and snot, and I'm sure your doctor is too.

HOW DOES THE COVID VACCINE WORK:
I'm going to post a link that you can visit.
https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/how-they-work.html

Lastly, I know some may be upset because we have shut down our waiting room and ask you to wait in your car until one becomes available. I'm doing it for your safety. I'm not going to allow my clinic to be a vector of disease. Secondly, if we have a patient test positive for COVID or Flu, we sterilize our rooms in a process that may last up to 30 minutes. I hate having longer wait times than usual but I'm not going to put your life at risk because we failed to create the most sanitized environment possible before being placed in our exam room.

01/01/2021

Happy New Year’s everyone!! I’ve gotten a lot of phone calls about my status with Amerigroup Tenncare. We ARE in network with Amerigroup and have been for quite some time. There was a paperwork issue for literally 2-3 days in October and they decided to send everyone new cards for reasons that puzzles me. You don’t not have to switch and I look forward to continuing my relationship with my Amerigroup patients.