Physician

Physician wellness is not yoga: Why resilience training fails

Physician
February 3, 2026

Let’s talk about physician wellness.

Not the version that looks good in press releases or PowerPoint slides. I am talking about the lived, messy, heart-and-body version of wellness, the one that actually matters.

Because somewhere between the lavender oil diffusers and the “wellness committees,” the real meaning of physician well-being got lost. It has become a buzzword, something hospitals display proudly on banners and conference agendas, as if saying the word “wellness” …

Read more…

The coffee stain metaphor: Overcoming perfectionism in medicine

Physician
February 3, 2026

I recently attended a very large professional conference. In a rush to make it everywhere and yet feed myself, I was running to get breakfast before the sessions and spilled the majority of this much-desired coffee all over my shirt. Here I was, standing with an impressive, unmistakable, impossible-to-hide giant stain of dark liquid spreading across the front of my solid blue shirt and sleeve with nothing to hide it.

It …

Read more…

From pediatrics to geriatrics: How treating children prepared me for dementia care

Physician
February 3, 2026

As a pediatrician, I spent many years in a busy, at times hectic, mostly enjoyable practice before retiring and segueing into teaching. Now as an adjunct professor in pediatrics, I aspire to help future health care workers pursue a career in pediatrics.

I have often asked myself: Have I missed anything about the day-to-day of practicing pediatrics?

My answer was what I truly missed were the interactions I had with the children: …

Read more…

Managing a Black Swan in health care: a lesson in transparency

Physician
February 2, 2026

An excerpt from On All Sides of the Bed: One physician’s/CEO’s journey.

In the early summer of 2013, our hospital collided with a Black Swan.

Before Europeans discovered Australia, they were familiar only with white swans. The discovery of black swans overturned a long-held assumption. In business and risk theory, a “Black Swan” refers to a rare, unpredictable event with massive consequences, a concept popularized by Nassim Nicholas Taleb. For us, …

Read more…

Health care as a human right vs. commodity: Resolving the paradox

Physician
February 2, 2026

Human rights are understood to be universal and egalitarian. They are inalienable, indivisible, and grounded in a shared moral intuition: that human dignity deserves protection. One of the most widely accepted expressions of that intuition is the obligation to care for those who are physically or emotionally ill. Yet despite this near-universal belief, modern health care systems continue to struggle with a fundamental question: Is health care a human right, …

Read more…

Deductive reasoning in medical malpractice: a quantitative approach

Physician
February 1, 2026

Conventionally, medical malpractice is argued using inductive reasoning. There is nothing wrong with inductive reasoning. It is a component of critical thinking. However, it is just a component. Inductive reasoning is more subjective than objective and the influences of selection bias, avoidance bias, and confirmation bias are undetectable.

Deductive reasoning is also a component of critical thinking. It is not immune from these same biases; however, deductive reasoning is more robust …

Read more…

Nervous system dysregulation vs. stress: Why “just relaxing” doesn’t work

Physician
January 31, 2026

During the COVID-19 pandemic, conversations about burnout and stress exploded, particularly among health care workers. Much of the advice centered on self-care practices: taking time off, scheduling massages and spa days, practicing mindfulness, protecting your evenings, using your PTO. While these strategies are valuable, they are not the full story.

Positioning self-care as the solution to stress oversimplifies a much deeper physiological process. For many patients (and clinicians) stress is not …

Read more…

A blueprint for pediatric residency training reform

Physician
January 31, 2026

The false promise of efficiency

The latest punditry calls for three-year medical schools, stripped of ethics and other vital subjects, with less clinical training. The rationale? Efficiency. The result? A generation of physicians unprepared for the complexity of children’s lives.

General pediatricians themselves admit in published surveys that they “know squat” about developmental-behavioral pediatrics (DBP) after residency. Yet the proposed solution is to shorten training further. That is not reform; it is …

Read more…

The gastroenterologist shortage: Why supply is falling behind demand

Physician
January 31, 2026

The story of gastroenterology in 2025 is no longer about productivity or reimbursement, it’s about manpower. Hospitals and practices across the U.S. are struggling to recruit, retain, or even temporarily staff the specialists who manage digestive diseases, perform colon cancer screening, and handle emergency procedures like ERCP. What we’re facing isn’t simply a staffing issue; it’s a structural shortage decades in the making.

The shrinking pipeline of gastroenterologists

In the mid-1990s, roughly …

Read more…

Disruptive physician labeling: a symptom of systemic burnout

Physician
January 30, 2026

More physicians than ever are reaching out for support after being labeled disruptive, inefficient, delinquent, reactive, or poor communicators.

These are highly skilled, deeply committed professionals being written up for professionalism concerns, communication issues, behavior, and “reactivity.” These cases span every specialty, gender, and stage of career.

This is not a reflection of declining professionalism. It is a predictable outcome of practicing in an untenable and broken system. It is an expected …

Read more…

Medicine changed me by subtraction: a physician’s evolution

Physician
January 30, 2026

I used to think medicine would change me by adding things. Knowledge. Confidence. Authority. Certainty. I assumed growth would look like accumulation, more skills, more answers, more control. What actually happened was the opposite. Medicine changed me by subtraction.

When I started writing as a medical student, everything felt sharp and exposed. The hospital was loud, inefficient, and often cruel in ways no one named out loud. I wrote about scut …

Read more…

The hidden costs of the physician non-clinical career transition

Physician
January 30, 2026

I entered medicine believing (perhaps naïvely) that experience mattered. Triple board certification, years of clinical practice across three specialties, and working in New York City felt like assets that would translate beyond the bedside. Like many burned-out physicians, I assumed that transitioning into a non-clinical role would be difficult, but not absurdly so.

I was wrong.

Over several years, I applied to what felt like thousands of positions in pharmaceutical companies, utilization …

Read more…

The poet who changed my DNA

Physician
January 29, 2026

In 1983, The Outsiders featured Robert Frost’s “Nothing Gold Can Stay” and, augmented by Francis Ford Coppola’s cinematic genius, it planted a seed, one I was unaware of at the time.

Nature’s first green is gold,
Her hardest hue to hold.
Her early leaf’s a flower;
But only so an hour.
Then leaf subsides to leaf.
So Eden sank to grief,
So dawn goes down to day.
Nothing gold can …

Read more…

ADVERTISEMENT

Why the real flex in life is freedom of time and self

Physician
January 28, 2026

You know the real flex in life is to be able to stretch out like a cat on a random Tuesday and not worry about bills or appointments or being anywhere.

I think there’s something truly to be said about time freedom (and not only time freedom, but freedom of self) where we can let go of the guilt and shame and all these things that hustle culture has ingrained in …

Read more…

Clinical attachment in medicine: How familiarity creates safety

Physician
January 28, 2026

You don’t learn this in medical school: Clinical familiarity creates attachment.

Not the kind we mean in romance. Not even the kind we mean in psychotherapy. Something quieter and more automatic, built through repetition and stakes.

You don’t have to say anything deeply personal for it to happen.

You just have to show up again. And again. And again.

Same hallway turns. Same waiting room chairs. Same voice calling your name. Same pace in …

Read more…

Why clinical excellence isn’t enough to sustain a physician-owned hospital

Physician
January 27, 2026

Most physicians begin their careers with a deeply held belief: If treatment is good, patients will come. It feels intuitively correct, and early in practice it often appears to be true. Clinical outcomes build trust, trust brings patients, and for a time the system seems to sustain itself. Yet after years of working inside physician-owned hospitals, group practices, and large corporate health systems, I have learned an uncomfortable truth. Good …

Read more…

Leading with love: a physician’s guide to clarity and compassion

Physician
January 26, 2026

In medicine, we are trained to lead with logic. To analyze, evaluate, and act. We are praised for decisive thinking, efficiency, and evidence-based decisions. In the hardest moments of my life, career, and leadership, none of those tools brought me clarity.

Ten years ago, as a practicing pediatrician and physician leader, my personal life began to fall apart. My husband, who had always been steady and supportive, began to slide into …

Read more…

Patient expectations in primary care: the structural mismatch

Physician
January 26, 2026

Patient frustration is something many of us carry home at the end of the day. Much of that frustration, however, isn’t personal; it’s structural.

Many patients don’t realize that different primary care models are designed to deliver fundamentally different experiences. They expect concierge-level access and time within insurance-based practices. They want same-day appointments, unhurried visits, and immediate physician availability, regardless of the model they’re in. And when we can’t deliver what …

Read more…

The telehealth trap: Why single-service roles lead to burnout

Physician
January 26, 2026

Across my career, including as CMIO of Kaiser Permanente’s Colorado medical group, I’ve had a front-row seat to how remote care and technology are reshaping clinical practice. I’ve also watched many colleagues make the shift to telehealth positions seeking flexibility and an escape from hospital and clinic burnout. These siloed jobs often lead to a different kind of burnout because they can be isolating, rote, and disconnected from actual systems …

Read more…

Multifactorial drivers of the U.S. physician shortage: a data analysis

Physician
January 25, 2026

The United States faces a worsening physician shortage despite increases in medical school enrollment and residency growth. This article provides a comprehensive, data-driven analysis of the multifactorial forces reducing effective physician supply. These include training-pathway inflation, declining board-certification throughput, shorter physician career duration, reduced reimbursement, the collapse of private practice, feminization of the workforce, declining IMG participation, and accelerating population aging. Tables and figures throughout this article illustrate how these …

Read more…

247
pages