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Dr. Lena Marsh, family physician in soft-collared shirt with stethoscope, warm natural light from window behind her
Let's figure
this out
together.

Real answers about your symptoms, written the way I explain things in the exam room β€” plain language, honest options, and a path forward. No alarm, no jargon.

🩺24 years in family medicine
⭐4.9 / 5 across 340 patient reviews
πŸ₯Accepting new patients now
Back PainSeasonal AllergiesHypertensionChildhood RashesAnxiety & SleepKnee PainDiabetes ManagementSore ThroatMigraineAcid RefluxFatiguePreventive Care
Back PainSeasonal AllergiesHypertensionChildhood RashesAnxiety & SleepKnee PainDiabetes ManagementSore ThroatMigraineAcid RefluxFatiguePreventive Care

The way patients describe it. The way medicine explains it.

Each card below opens the way a conversation in my office does β€” starting with what you feel, moving to what's happening, and ending with what we can do about it.

Conditions covered

200+

in our full reference

Common Symptoms

  • Stiffness worse in the first 30 minutes
  • Aching that eases with movement
  • Occasional radiating sensation down the leg
  • Difficulty bending forward

Treatment Paths

Conservative first

Targeted stretching, posture coaching, NSAIDs for 5–7 days

Physical therapy

Referral if symptoms persist beyond 4–6 weeks

Imaging if needed

X-ray or MRI only when red flags appear or conservative care fails

When to seek urgent care

Numbness, weakness in the legs, or loss of bladder/bowel control β€” call us same day.

What your first visit looks like

We'll talk through your posture, work habits, and activity level. I'll do a quick physical exam and we'll build a plan β€” usually stretches, activity modifications, and sometimes a short course of anti-inflammatories.

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Common Symptoms

  • Flat or raised red spots
  • Appears with or after a mild fever
  • Itching varies widely
  • May spread head-to-toe over 24–48 hrs

Treatment Paths

Watch and wait

Viral rashes typically resolve in 3–7 days without treatment

Topical relief

Hydrocortisone or antihistamine for itching and inflammation

Allergy workup

If rashes recur, we test for contact allergens or food triggers

When to seek urgent care

A rash that doesn't blanch when you press it (press test), difficulty breathing, or swelling of lips/face β€” go to the ER immediately.

What your first visit looks like

Bring a photo if the rash changes before your appointment. I'll look at the pattern, ask about recent illnesses and new exposures, and usually we'll know the cause within minutes.

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Common Symptoms

  • Aching front of knee going downstairs or squatting
  • Stiffness after sitting for long periods
  • Occasional clicking or grinding sensation
  • Swelling after activity

Treatment Paths

Strengthening first

Quad and hip strengthening reduces patellofemoral load by 30–40%

Injection therapy

Corticosteroid or hyaluronic acid for moderate osteoarthritis

Orthopaedic referral

For structural damage or when conservative care plateaus after 3 months

When to seek urgent care

Sudden severe swelling, locking of the joint, or inability to bear weight after a fall or twist β€” come in that day.

What your first visit looks like

I'll watch you walk, assess range of motion, and check the joint. We'll discuss activity level and weight, and I'll explain what the anatomy is doing. X-ray is often helpful here.

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Common Symptoms

  • Difficulty falling or staying asleep
  • Racing thoughts at bedtime
  • Muscle tension, especially neck and jaw
  • Daytime fatigue and difficulty concentrating

Treatment Paths

Sleep hygiene + CBT-I

Cognitive Behavioral Therapy for Insomnia outperforms sleep medication long-term

Short-term medication

Non-habit-forming options to break the cycle while building better habits

Therapy referral

We have trusted therapists in our referral network for ongoing anxiety support

When to seek urgent care

If you're having thoughts of harming yourself, please call 988 (Suicide & Crisis Lifeline) or go to your nearest ER. For everything else, let's talk.

What your first visit looks like

No judgment, no rush. We'll go through what's happening in your life, rule out physical causes (thyroid, iron, sleep apnea), and map out a plan that might include lifestyle changes, therapy referral, or medication β€” your choice.

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Common Symptoms

  • Usually no symptoms at all
  • Occasional headache (not a reliable sign)
  • Discovered incidentally on screening
  • Sometimes dizziness or visual changes at very high levels

Treatment Paths

Lifestyle first

DASH diet, sodium reduction, and 150 min/week exercise can lower BP by 5–10 mmHg

First-line medication

ACE inhibitors or thiazide diuretics β€” effective, affordable, well-tolerated

Monitoring plan

Home BP log + quarterly check-ins to titrate and adjust

When to seek urgent care

BP above 180/120 with headache, chest pain, or vision changes is a hypertensive urgency β€” go to the ER.

What your first visit looks like

We'll take multiple readings, review your diet and family history, and check your kidney function and cholesterol. Most people with Stage 1 hypertension start with lifestyle changes before medication.

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Common Symptoms

  • Burning sensation rising from chest to throat
  • Worse lying down or after large meals
  • Sour taste in the mouth
  • Chronic cough or hoarseness (less obvious sign)

Treatment Paths

Lifestyle + timing

Elevation of head, no food 3 hrs before bed, identifying trigger foods

Proton pump inhibitors

Highly effective short-term; we aim to use the lowest dose for the shortest time

GI referral

Endoscopy if symptoms persist, age over 50, or alarm features are present

When to seek urgent care

Difficulty swallowing, unintentional weight loss, or vomiting blood β€” these need same-week evaluation.

What your first visit looks like

We'll go over your meal patterns, triggers, and current medications. Most cases are managed without a scope β€” but I'll tell you honestly when you need one.

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Looking for a condition not listed here?

Ask during your first visit β€” I've likely seen it

A path forward, not a prescription pad.

Treatment at Remedy starts with understanding before it starts with prescribing. Here's how we think through your care.

Treatment Philosophy

We start with the least invasive path that actually works.

Every treatment decision is a conversation. I explain the options, the evidence behind each, and what I'd recommend for you specifically β€” not the average patient.

87%

resolved without specialist referral

< 3 days

average wait for an appointment

Physician drawing a treatment diagram on paper at a desk with natural light, warm and unhurried

β€œI still draw diagrams on paper. It's the fastest way to make something click.”

β€” Dr. Lena Marsh

Decision Tree

How we choose your treatment path

1
Listen to your full story
2
Physical exam + relevant tests
3
Evidence-based options, plain language
4
Your preferences shape the plan
By the numbers

24yrs

in practice

4,800+

active patients

98%

would recommend

0

referral required

When I refer you to a specialist, I tell you exactly why.

Referrals happen when a condition genuinely needs specialist expertise β€” not as a default. You leave with a clear explanation, a warm handoff, and my contact info if questions come up.

Dr. Lena Marsh, family physician, warm smile, stethoscope around neck, natural light from window, plant visible on shelf behind her
Lead Physician

Dr. Lena Marsh

MD, FAAFP Β· Family Medicine Β· Est. 2002

4.9 Β· 340 reviews

β€œMedicine works best when it's a conversation, not a transaction. My job is to give you enough understanding that you can make decisions with confidence β€” not just follow instructions.”

Board Certified ABFM β€” American Board of Family Medicine
Medical School University of Washington School of Medicine
Residency UCSF Family & Community Medicine
Hospital Affiliation Riverside General, attending privileges
Languages English, conversational Spanish

24+

Years in practice

4,800+

Active patients

200+

Conditions treated

Patient voices

From the people who know this practice best.

β€œ

Dr. Marsh explained my daughter's eczema in a way that finally made sense. She drew a diagram of the skin barrier on a notepad. My daughter still has it on her wall.

Patricia Holloway, smiling woman in her 40s with brown hair

Patricia Holloway

Mother of two, patient for 6 years

β€œ

I came in convinced I needed an MRI for my back. She spent 20 minutes with me, did a physical exam, and told me exactly what was happening and why I didn't need one yet. First doctor who ever talked me out of an unnecessary test.

Marcus Reyes, man in his 60s with grey temples and glasses

Marcus J. Reyes

Retired engineer, patient for 3 years

β€œ

I moved here from Seattle and dreaded starting over with a new doctor. Within two appointments I felt like she'd known me for years. The online condition library helped me prepare for our first visit β€” I came in with better questions.

Anika Patel, young woman in her 30s with dark hair, smiling

Anika Patel

Software designer, patient for 2 years

Book Your First Visit

New patients are welcome. Most appointments available within 3 days. We'll confirm your slot by email within 2 hours.

No credit card required Β· Confirmation within 2 hours Β· New patients welcome

What your first visit looks like

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45 minutes, not 10

New patient appointments are never rushed. We have time to actually talk.

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Bring your questions

There's no such thing as a dumb question in this office. Write them down.

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Medication list welcome

If you take anything β€” prescriptions, supplements, OTC β€” bring the bottles.

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Prior records helpful

We can request records too, but anything you have speeds things up.

Download the Symptom Guide

Free PDF Β· 24 common conditions explained

Not ready to book? Take the reference guide home. It covers 24 common conditions with plain-language explanations and a checklist of questions to ask your doctor.

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Location

2840 Clement St, San Francisco, CA 94121

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Phone

(415) 555-0172

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Hours

Mon–Fri 8am–6pm Β· Sat 9am–1pm

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Parking

Street parking on Clement + Geary