Physician

A pediatrician’s role in national research

Physician
October 19, 2025

I was not just a contributor. I was the pediatrician in the room, the one who translated clinical reality into research clarity, even when the system preferred abstraction.

From 1997 to 2003, I lived a six-year burst of energy: equal parts clinical invention, research precision, and institutional resistance. It was my Trinity Site: a catalytic moment where everything fused: rural care delivery, editorial rigor, and systems reform. The fallout still shapes …

Read more…

The danger of calling medicine a “calling”

Physician
October 19, 2025

The idea that medicine is a “calling” has been entwined deeply within our profession. From white coat ceremonies to recruitment posters featuring smiling doctors holding stethoscopes, we are told that to enter medicine is to answer a higher purpose. This framing is powerful. It inspires loyalty, fuels commitment, and builds identity. That is how the brainwashing begins as it also hides a dangerous truth: Labeling medicine as a calling has …

Read more…

Physician work-life balance and family

Physician
October 18, 2025

As a parent and a doctor of nearly four decades, I’ve often found myself navigating the rugged terrain of a dual existence: the life of a devoted physician, and the life of a dedicated parent. I have not always succeeded in both arenas. My wife and I both bear the weight of our professions, drawn into the noble yet demanding world of medicine. Our missions and ambitions, while fulfilling, have …

Read more…

Love and loss in the oncology ward

Physician
October 17, 2025

In the quiet moments of illness, I witness love and loss unfold.

I usually place the beds of relatively sick patients closest to my workstation. While I can monitor all the patients, except for a few female beds behind curtains, this arrangement helps me keep a closer eye on those who are more ill, particularly those receiving chemotherapy.

Directly in front of my counter lies a 50-year-old gentleman recently diagnosed with primary …

Read more…

The weight of genetic testing in a family

Physician
October 17, 2025

An excerpt from Held Together: A Shared Memoir of Motherhood, Medicine, and Imperfect Love.

Scott and I held hands as the last few minutes of waiting expanded to rival the anticipation of the days that had already passed. Two weeks ago at this same medical center, our perinatologist had performed a chorionic villus sampling, the procedure to collect the fragment of placenta that would determine our course. I had been …

Read more…

A surgeon’s view on RVUs and moral injury

Physician
October 17, 2025

For over forty years, I worked as a general and vascular surgeon. For the last ten of those years, I was employed under an RVU-based compensation model. That period is when my dissatisfaction with medicine truly began. Complex, life-saving operations were reduced to “productivity units.” The pressure was relentless, the system unforgiving.

And unlike primary care physicians, surgeons do not have the option of concierge or direct-pay models. We are necessarily …

Read more…

Reclaiming moral ambition in health care

Physician
October 16, 2025

When I started practicing medicine more than thirty years ago, I believed the system was imperfect but noble. We worked hard, we cared deeply, and I thought that if we just kept doing our best, things would gradually improve. I trusted that technology, new policies, and better organization would eventually bring us closer to the ideals of medicine. Some of those changes helped. Many did not.

If I am honest, there …

Read more…

When language barriers become a medical emergency

Physician
October 16, 2025

She clutched her chest, gasping for words that would not come in English. The nurse leaned in, trying to decipher. Her son was not there to translate, and the phone interpreter line was not connected yet. I could see her distress worsening. Precious minutes slipped away before we finally realized she was describing classic heart attack symptoms. That patient survived, but the outcome could easily have been different. And in …

Read more…

The burden of the eldest daughter

Physician
October 15, 2025

Were you the one who always held it together? The responsible one? The one who made sure everyone else was okay, sometimes at the cost of your own well-being?

For most eldest daughters, this role is inevitable. We don’t choose it. We are handed it, early and often, because we are so “capable.” We accept this role and excel at it. That’s what most eldest daughters do with whatever is handed …

Read more…

A doctor’s letter from a federal prison

Physician
October 15, 2025

Understanding the legal process in America is not easy, and I do not envy the attorneys who try to defend doctors in court. I do envy them for their protections. Lawyers, for the most part, as elected members of Congress, create our laws. Others, also for the most part lawyers, are selected to be U.S. Attorneys, and they enforce those laws. Lawyers called judges control our courtrooms. Almost all of …

Read more…

A doctor’s tribute to her father

Physician
October 14, 2025

“Who would you go on a date with, and why?” That was the question that came up in a recent speech workshop. People shared fun, lighthearted answers. But for me, the answer came straight from my heart. I would go on a date with my dad.

My father passed away nearly fifteen years ago, just before my life was about to begin a whole new chapter. I was newly married, preparing …

Read more…

Treating autism and ADHD as a spectrum, not a contradiction

Physician
October 14, 2025

He was five, wiry, and fast, so fast his mother looped her purse strap around his wrist in the waiting room. She spoke softly, in Spanish, explaining that he could not sit still, could not sleep, could not stop. As she described his meltdowns, he interrupted with nonsense sentences, unrelated to her words, untethered from context. It was not defiance; it was overflow.

I and my team of CNA Spanish interpreters …

Read more…

The silent victories of medicine

Physician
October 13, 2025

Some battles announce themselves with trumpets; others creep in silently, spreading their fire unseen. His battle was the latter. What began as a hidden spark in his muscles had grown into an inferno consuming his young body from within.

He was barely thirteen, a boy from Bihar, when fate dragged him into this fight. By the time he reached us, fever had bound him for three relentless weeks. His pulse was …

Read more…

ADVERTISEMENT

A cancer doctor’s warning about the future of medicine

Physician
October 13, 2025

I am a cancer doctor.

It took me many years to become one and while I paid for my medical school tuition, my residency and fellowship training was partially subsidized by government funds for general medical education. Every residency and fellowship is partially funded this way because the government recognizes the need for doctors. I have also had an NIH funded basic research lab where I did research that has contributed …

Read more…

Teaching medical students what it is really like to be a physician

Physician
October 12, 2025

Physician burnout and physician suicide continue to plague the medical profession. Everyone knows the tragic statistic: one U.S. physician commits suicide each day. While some statistics report a decrease in the problem over time, the accuracy of these reports is questionable. The reality is that it is far too common.

The term burnout, while a necessary label, implies that a single factor causes it. In reality, each burned-out physician is different. …

Read more…

The hypocrisy of insurance referral mandates

Physician
October 11, 2025

Every week, I see patients not because they need to, but because their insurance company says they must. A patient came in recently for one reason only: Her insurer required a referral before she could see a specialist. She didn’t want to. I didn’t need her to. But we both had no choice. After a 20-minute visit neither of us needed, I did what the insurer required: document, click, submit. …

Read more…

The timeless art of diagnostic reasoning

Physician
October 11, 2025

The patient was in her forties. She experienced chest pain, but it did not appear to be “classic.” Her ECG was normal. Her labs did not raise alarms. The team leaned toward anxiety. Hours later, she went into cardiac arrest from a heart attack. That silence after the code still stays with me. We anchored on the first test. We closed the case too early. We stopped listening to her …

Read more…

What MS can teach cardiologists about disease

Physician
October 10, 2025

At the recent ECTRIMS Congress in Barcelona, researchers presented data that should make every specialist pause. In a claims analysis of nearly 70,000 patients with multiple sclerosis (MS), 98 percent of infections were first detected not in neurology clinics, but in primary care and other non-neurology practices. Even “serious” infections requiring hospitalization were almost entirely picked up elsewhere. The message was clear: Specialists, by design, often miss the forest for …

Read more…

What an active shooter taught me about being a doctor

Physician
October 10, 2025

“Do you know what it feels like, to know you could die at any moment?” His words linger in the air, heavy, long after the threat of violence has passed, long after our team has calmed him with words and soft gestures. It is not the first time a patient’s family member has swung at me, nor will it be the last. But it is the first time with a …

Read more…

Physician leadership in moments of crisis

Physician
October 10, 2025

There’s a common belief that leadership requires a title after your name, an office on the top floor, and people looking to you for direction. But in medicine, leadership happens at every level.

Take me, for example. I’m an attending physician, whose role on the team is as a hospitalist. In the hierarchy of medicine, it’s easy to dismiss this role as “just a physician.”

Yet there’s nothing “just” about it when …

Read more…

235
pages