Santa Monica Primary Care

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 o

utpatient 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.

Some genuinely good news to close this month's newsletter: the US death rate fell to its lowest level ever recorded in 2...
09/09/2026

Some genuinely good news to close this month's newsletter: the US death rate fell to its lowest level ever recorded in 2025 -- 689.2 deaths per 100,000 people, a 4.6% drop from 2024. The decline showed up across every age group and both sexes, and life expectancy is expected to hit a new record once the final numbers are calculated. A big driver: drug overdose deaths kept falling, especially among adults 25 to 34, where the death rate dropped from 124.5 to 111.1 per 100,000 in a single year -- a real bend in a decade-long, opioid-driven trend.

But one line in the data stands out against all that good news: influenza climbed from the 11th to the 8th leading cause of death nationally this year, at the same time adult flu vaccination coverage fell to its lowest point in about seven seasons -- 41.9%, down from 52.2% just four seasons ago. Almost every other mortality trend improved in 2025. The one respiratory illness with a decades-old, well-studied vaccine moved in the wrong direction. If you haven't scheduled your flu shot yet, this is a good nudge to put it on the calendar for October.

An update on the cyclospora outbreak we first mentioned in July: case counts have climbed past 24,000 nationally, includ...
09/04/2026

An update on the cyclospora outbreak we first mentioned in July: case counts have climbed past 24,000 nationally, including at least 740 hospitalizations.

For comparison, the entire 2025 season totaled just 1,180 cases -- this outbreak is more than 20 times that. The source remains iceberg lettuce from Taylor Farms de Mexico, which made its way into fast-casual restaurant chains including Taco Bell. The recall is weeks old now, but new cases are still being reported because of the parasite's incubation period and reporting lag.

The good news: in healthy adults, this is typically a self-limited illness -- watery diarrhea, bloating, fatigue, occasionally a low-grade fever. The standard treatment works well, though it's worth knowing that if you have a sulfa allergy, options are more limited. If you or a family member have had prolonged watery diarrhea since late June, especially after eating shredded lettuce or a fast-casual salad, call our office rather than waiting it out.

Two useful flu updates as we head toward fall:First, a head-to-head trial (the first of its kind) compared the three mai...
09/01/2026

Two useful flu updates as we head toward fall:

First, a head-to-head trial (the first of its kind) compared the three main antiviral flu treatments against each other. Baloxavir (brand name Xofluza) cleared detectable virus the fastest, followed by favipiravir and then oseltamivir (Tamiflu). But here's the catch worth knowing before your next urgent care visit: none of the three drugs got patients feeling fully better any sooner. They clear viruses faster -- useful for reducing how long you're contagious -- but "feeling sick" doesn't reliably resolve any quicker.

Second, a large study of adults 65 and older across four flu seasons in Japan found something counterintuitive: getting the shot slightly later in the season sometimes tracked with fewer flu cases. But when researchers looked at deaths from any cause, early vaccination -- specifically, getting the shot in October -- consistently won out, every single season studied. That's the number we trust more, and it's why we'll keep recommending October for our patients 65 and up.

You may have seen a study circulating online, and referenced recently in a Senate hearing, claiming COVID-19 vaccines co...
08/27/2026

You may have seen a study circulating online, and referenced recently in a Senate hearing, claiming COVID-19 vaccines contributed to ongoing excess deaths in 2020-2022. That paper was formally retracted on August 11th.

Here's the short version: the paper never actually tested whether vaccines caused excess deaths -- it just noted that both vaccines and continued excess deaths existed in the same time period, and spent most of its discussion arguing they might be connected. When an independent actuary went back and checked the paper's own numbers properly, countries with higher vaccination rates actually had lower excess deaths -- the opposite of what the paper implied. On top of that, the researcher whose dataset the paper relied on found large sections of text and analysis that had been copied from his own prior work without credit.

It took two years and a Senate hearing citation for the retraction to happen. We share this not to dunk on one bad paper, but because this is exactly the kind of study that ends up forwarded in a family group chat with the caption "see, I told you." If something you've read about vaccines seems alarming, we're always happy to look at the actual source with you.

Last month we told you about BARCODE1, a saliva-based genetic test for prostate cancer risk. This month brings its cardi...
08/25/2026

Last month we told you about BARCODE1, a saliva-based genetic test for prostate cancer risk. This month brings its cardiovascular counterpart: a single blood or saliva sample that now reports genetic risk across eight conditions at once -- coronary artery disease, type 2 diabetes, atrial fibrillation, high cholesterol, high blood pressure, blood clots, aortic aneurysm, and elevated Lp(a), a cholesterol-related risk factor that's almost entirely determined by genetics rather than diet or lifestyle.

Where this test earns its keep clinically is with patients stuck in the gray zone -- borderline cholesterol, a family history that raises questions, but no clear answer from a standard risk calculator. This score doesn't replace that calculator; it adds a layer of information that's fixed at birth and doesn't change with this year's lab work, which is exactly what's useful when the usual numbers leave real ambiguity.

We offer this testing through our partnership with Biography Health. If you've already completed genetic testing with them, there's no need to retest -- we can query your existing results directly. Ask us at your next visit whether this makes sense for you.

You may have seen headlines about a new executive order on childhood vaccines. Here's what it actually does, and doesn't...
08/21/2026

You may have seen headlines about a new executive order on childhood vaccines. Here's what it actually does, and doesn't do: it directs HHS to look into splitting the combined MMR vaccine into three separate shots -- but those three products don't exist yet anywhere in the US market. The combined MMR has been used safely since 1971, built on a measles component in continuous use since 1963. Nothing about this order changes what we recommend or what's available at our office today.

Here's the number that actually matters for your family: measles is the most contagious pathogen we deal with in medicine. One infected person can pass it to 12 to 18 others in a susceptible population -- compare that to about 1 to 2 for seasonal flu. US measles cases are already at a 35-year high. The science on MMR and autism has been asked and answered many times over, across more than a million children in multiple countries, and it keeps coming back the same way: no link. Staying current on MMR is still the best way to protect your kids -- and the adults around them who assume their childhood shots or one booster still fully cover them.

Questions about your family's vaccine status? Give us a call.

Full clinical deep dive: https://drbretsky.com/pages/post.html?id=10468

The single most common question in myoffice right now, so let’s use real numbers instead of vibes. What’s genuinely stro...
08/14/2026

The single most common question in my
office right now, so let’s use real numbers instead of vibes.

What’s genuinely strong: in the SELECT trial, semaglutide cut major cardiovascular events by 20% in adults with obesity and existing heart disease — a hard outcome, not a proxy.

The catch nobody mentions: that trial population was high-risk. Benefit scales with your starting risk, the same rule that’s held for statins and blood pressure meds for decades. We don’t have clean data yet on benefit in lower-risk patients.

What happens if you stop: in STEP 1’s extension study, patients regained two-thirds of their lost weight within a year of stopping. That’s not a willpower failure — it’s biology reasserting itself, the same way blood pressure climbs back after you stop an antihypertensive.

One more thing: 20–25% of weight lost on these drugs is lean mass, not fat. Pair treatment with resistance training and adequate protein from day one.

These are excellent medications for the right patient, with an actual plan. Let’s figure out if that’s you.

Full clinical deep-dive: drbretsky.com/newsletters

For patients who’ve hit a wall on statins, or who’ve avoided the injectable PCSK9 drugs (Repatha, Praluent) over needles...
08/10/2026

For patients who’ve hit a wall on statins, or who’ve avoided the injectable PCSK9 drugs (Repatha, Praluent) over needles, there’s real news: an investigational once-daily oral PCSK9 inhibitor just posted Phase 3 results showing LDL-C reductions of 56–65% — in the same range as the injectables, with
a placebo-like safety profile.

Why this matters beyond convenience: PCSK9 inhibitors as a class are one of the only therapies that move Lp(a) at all — statins don’t touch it, and can even nudge it up. That class-level Lp(a) effect is modest, not a cure (this specific trial’s data is about LDL-C, not Lp(a)) — but for anyone with elevated Lp(a) and
genuinely limited options, “modest and real” beats “nothing.”

This drug isn’t FDA-approved yet, and it’s arriving the same month a new guideline made 21.5 million more Americans statin-eligible. Easier access to a good drug isn’t automatically a reason to start it. If your numbers have shifted, let’s review your actual risk.

Full piece drbretsky.com/newsletters

An FDA advisory panel just voted, 8–6, to recommend BPC-157 for widespread compounding-pharmacy access — overruling thei...
08/06/2026

An FDA advisory panel just voted, 8–6, to recommend BPC-157 for widespread compounding-pharmacy access — overruling their own agency’s scientists, who’d recommended against it. Before you read that as either a scandal or a green light, let’s be precise about what the evidence actually says.

BPC-157 has roughly two decades of animal research behind it — genuinely substantial preclinical data. What’s missing isn’t evidence, it’s human evidence: dosing data, pharmacokinetics in people, controlled outcome trials. That’s a different problem than “nothing’s there,” and it deserves a different response than blanket dismissal.

Here’s the part that matters more than any one vote: FDA drug approval comes bundled with mandatory follow-up —
registries, monitoring, structured trials. Compounding-pharmacy access carries none of that.

If you’re asking your doctor about a peptide, the right question isn’t “will you prescribe it” — it’s “what specifically are you going to measure before and after.”

Full analysis: drbretsky.com/newsletters

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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

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