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Nutrition in pediatric oncology is not a fixed meal plan

Dr. Manjari Chandra

October 25, 2026Oct 25, 2026

In pediatric oncology, nutrition is often reduced to a simple question: Is the child eating enough? In practice, it is rarely that straightforward. During intensive cancer treatment, appetite, swallowing, taste, gastrointestinal tolerance, body weight, body composition, and functional capacity can change within days. A nutrition plan that works well in one phase of treatment may become difficult, or even impossible, a few weeks later.

This is the journey of a twelve-year-old …

Accelerated TMS: what the SAINT and SWIFT numbers mean

Ravi Singareddy, MD

October 25, 2026Oct 25, 2026

More and more patients now ask me about "five-day TMS for depression." Some have read about Stanford's protocol. Others have seen clinics advertise two-week treatment. Referring colleagues ask a version of the same question: Is accelerated transcranial magnetic stimulation better,…

More and more patients now ask me about “five-day TMS for depression.” Some have read about Stanford’s protocol. Others have seen clinics advertise two-week treatment. Referring colleagues ask a version of the same question: Is accelerated transcranial magnetic stimulation better, and which protocol should patients look for?

The honest answer starts with a caveat. SAINT, now marketed as Stanford Neuromodulation Therapy (SNT), has reported higher remission rates than SWIFT, an accelerated …

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Physician finance

The true meaning of financial independence for doctors

Bruno Casanova, MD

October 25, 2026Oct 25, 2026

Doctors earn millions of dollars over the course of their careers and save only a small portion of it. That is not simply because most doctors lack financial literacy. It is also because of the personal circumstances each of us…

To become a fully trained doctor, you first set up a path and a timeframe …

Narinder Singh Parhar, MD

Why stool consistency matters, not just how often you go

Larry Kaskel, MD

October 25, 2026Oct 25, 2026

After more than thirty-five years practicing internal medicine, I've come to appreciate something that received remarkably little attention during my medical education. A good bowel movement is as much a problem of physics as it is of physiology. We spend…

After more than thirty-five years practicing internal medicine, I’ve come to appreciate something that received remarkably little attention during my medical education. A good bowel movement is as much a problem of physics as it is of physiology.

We spend years learning about gastrointestinal hormones, digestive enzymes, microbiology, inflammation, and intestinal motility. We memorize the causes of constipation and diarrhea. We prescribe medications, recommend fiber, and order colonoscopies.

But here’s a question …

Patient voices

Insurance referrals treat adults like schoolchildren

Anonymous

October 25, 2026Oct 25, 2026

For anyone with their finger on the pulse of American medicine, it is clear that referrals to see specialists as required by many health insurance plans have become a serious problem for doctors and patients alike. Primary care physicians often resent the time that these referrals take out of their day. Many also resent the fact that patients sometimes make appointments for no other reason than to …

Health technology

AI in health care must not cost us our human skills

October 25, 2026Oct 25, 2026

Artificial intelligence, robotics, and other emerging technologies are transforming health care at an extraordinary pace. Their potential is enormous, and their development is both welcome and increasingly necessary. As populations age, health care systems will face growing demands for medical…

As populations age, health care systems will face growing demands for medical care, rehabilitation, long-term support, and assistance for people with disabilities. Meanwhile, the volume of medical and pharmaceutical knowledge has expanded beyond what any individual clinician can reasonably master. AI-assisted clinical decision …

Patient voices

Medical gaslighting nearly killed me

Genené D. Prince-Walker, MPH

October 25, 2026Oct 25, 2026

There I was lying on my bathroom floor: semi-conscious, teeth-chattering; relieved my fever-sweat was plastering my back to the cold tile. I was weak, trying my best to will my body to the warmth of an elusive ray of light bouncing off the floor, playing hide-and-seek behind a transient cloud. Whenever the light flickered across my face, it seared straight through my squinted eyelids and settled on top of the …

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Medical gaslighting nearly killed me

The question to ask new patients that intake forms skip

Timothy Lesaca, MD

October 25, 2026Oct 25, 2026

The first patient appointment begins long before we introduce ourselves. Patients often spend days gathering records, completing forms, reading about symptoms, and contemplating what we might say. As a result, by the time we meet, they may also have formed expectations about how we will respond. They may have read your biography and online reviews, but those descriptions cannot tell them whether you will welcome a difficult question or let …

What is physician career success without a trophy case?

Jayson Greenberg, MD

October 25, 2026Oct 25, 2026

I recently read a press release announcing a physician as the new head of a regional health system. Among his accomplishments were six consecutive "Top Doctor" citations and a long list of other accolades. Closer to the end of my…

I recently read a press release announcing a physician as the new head of a regional health system. Among his accomplishments were six consecutive “Top Doctor” citations and a long list of other accolades. Closer to the end of my career than the beginning, I found myself taking stock of my accomplishments. My trophy case looked decidedly sparse in comparison, and I started to question my legacy and impact.

My trophy …

Fired for seeing her own patients: moral injury and life after medicine [PODCAST]

October 24, 2026Oct 24, 2026

A physician was fired by the doctors she had trained, in part because she preferred to see her own patients herself. Moral injury, she argues, does not require 100-hour weeks. Sarah A. Vlach is a physiatrist and sports medicine physician.…

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Erta Priadi Wirawijaya, MD

What happens after hypertension screening finds a problem?

October 24, 2026Oct 24, 2026

A blood pressure cuff can identify risk in less than a minute. A health system has to keep acting for years. Indonesia is learning that distinction at enormous scale. In August 2026, the Ministry of Health reported that about one…

A blood pressure cuff can identify risk in less than a minute. A health system has to keep acting for years.

Indonesia is learning that distinction at enormous scale. In August 2026, the Ministry of Health reported that about one million people were newly detected with hypertension among 9.2 million participants in the country’s free health-check program who had not been found to have high blood pressure the previous year.

The headline …

Medical storytelling and the doctor who forgot his lines

Ian Barbash, MD

October 24, 2026Oct 24, 2026

It wasn't a great performance. It might not even have been good. But I did it. When I stepped down from the stage, I just felt relieved. I had diligently memorized my lines. I started off by telling the audience…

It wasn’t a great performance. It might not even have been good. But I did it. When I stepped down from the stage, I just felt relieved.

I had diligently memorized my lines. I started off by telling the audience about the time I nearly tipped over trying to put on my underwear. That drew a laugh, as I had hoped it would. For the next seven minutes, the performance went …

Health policy

Surgery center profit margins were highest at nonprofits

Brian Hudes, MD

October 24, 2026Oct 24, 2026

A research letter published in JAMA Health Forum on September 25, 2026, examined the 2024 financial reports of 257 ambulatory surgery centers (ASCs) in Pennsylvania. The finding was not what the usual debate over outpatient medicine would lead you to…

Nonprofit centers represented 20.6 percent of the facilities. They collected 35.8 percent of the revenue and earned 51.5 percent of the net income. Their median profit margin was 37.8 percent. …

Surgical pipeline visibility starts with the coordinator

Alisa Vaughn

October 24, 2026Oct 24, 2026

Specialty practices are investing in executive dashboards that show surgical pipeline, volume projections, and cases at risk. Most of them are looking at a picture that is days behind. The reason is that the surgical coordinator responsible for keeping those cases moving is still working the case in a spreadsheet, an inbox, and a phone queue, and entering it into the system of record whenever there is time. If the …

How serial patent litigation delays cheaper generic drugs

Reuben Mathew, MD

October 24, 2026Oct 24, 2026

As a physician caring for patients in New Orleans, I see the consequences of America's prescription drug affordability crisis every day. Many of my patients need essential medications like insulin, blood thinners, and inhalers to manage chronic conditions that impact…

As a physician caring for patients in New Orleans, I see the consequences of America’s prescription drug affordability crisis every day. Many of my patients need essential medications like insulin, blood thinners, and inhalers to manage chronic conditions that impact their day-to-day lives. But far too often, these medicines are unaffordable, even for patients with solid health insurance.

One major reason prescription medicines are so expensive is a little-known Big Pharma …

Frivolous malpractice lawsuits need a quantitative test

Howard Smith, MD

October 24, 2026Oct 24, 2026

Many books describe medical malpractice. Among them are Medical Malpractice; Medical Malpractice: A Physician's Sourcebook; The Malpractice Myth; A Measure of Malpractice: Medical Injury, Malpractice Litigation, and Patient Compensation; Medical Malpractice: Theory, Evidence, and Public Policy; To Err Is Human;…

Many books describe medical malpractice. Among them are Medical Malpractice; Medical Malpractice: A Physician’s Sourcebook; The Malpractice Myth; A Measure of Malpractice: Medical Injury, Malpractice Litigation, and Patient Compensation; Medical Malpractice: Theory, Evidence, and Public Policy; To Err Is Human; Medical Law and Ethics; and Medical Liability and Treatment Relationships: A Physician’s Insight Into Medical Negligence. These are all described as “groundbreaking.”

I developed a decision-making method that I call Collate, …

What 3 bicycles taught me about physician resilience

Ronald L. Lindsay, MD

October 24, 2026Oct 24, 2026

When I was ten years old in Japan, I got a bicycle. It was a simple machine: one speed, coaster brake, no gears, and no pretensions. Designed for the flat Kanto Plain surrounding Tokyo, it was perfectly suited for its environment. For the next decade, it carried me through childhood, adolescence, and multiple moves as an Air Force dependent. The bicycle never failed me.

After my father died and our family …

Why storytelling in health care outlasts the algorithm

Ryan McCarthy, MD

October 24, 2026Oct 24, 2026

On Friday, March 13, 2020, Governor Jim Justice held a press conference, one I watched virtually, and, as I ate cheddar cheese and Triscuits and put my feet on my desk, I felt unwell. The previous weekend had been the last “normal” thing my son, Isaac, would do in high school, the West Virginia All-State High School Band. And by “normal” I mean a superspreader event where my entire family …

Disability claim denied? Your chart notes may be why. [PODCAST]