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Why do physicians freeze with LGBTQ+ patients?

Conditions and Diseases

August 31, 2026

“Doc, your next patient is nonbinary.” I say some version of this to physicians when I teach about LGBTQ+ affirming care, then ask, “What is the first thought that comes to mind?” The responses come quickly: “I freeze.” “Oh, God. We were never taught that.” “I don’t know what to say.” “I don’t want to say the wrong thing.” Sometimes there is nervous laughter. Sometimes there is silence.

These are highly …

Why AI governance in health care cannot be backdated

Neel Chauhan, MD, MBA

Health Technology

August 31, 2026

On July 29, Hackensack Meridian Health became the first health system in the country to earn The Joint Commission’s Responsible Use of AI in Health Care certification. Most coverage treated it as a milestone for one New Jersey network. I read it as a deadline for everyone else, because of a single question that certification normalizes, and that most organizations cannot yet answer.

The question is: “Show me this model.”

Not your …

Why ambient AI scribe notes fail the 2026 CMS audit

Kaif Ruman

Health Technology

August 31, 2026

The 2026 clinical landscape is witnessing a profound documentation paradox. While ambient AI scribes are celebrated for reducing “pajama time,” new data suggests they may be creating a systemic Attestation Gap. Research published in JAMA Network Open found that burnout prevalence dropped from 51.9 percent to 38.8 percent after the adoption of ambient tools, but the study did not measure documentation quality as an outcome. This raises the question …

Are peptides safe? What the evidence actually shows

John K. Smith, MD

Medications

August 31, 2026

Peptides are rapidly becoming one of the most talked-about developments in modern medicine. They are being positioned as solutions for weight loss, muscle recovery, anti-aging, skin health, and overall performance. Patients are increasingly arriving at appointments with detailed questions about specific compounds, often influenced by social media, wellness clinics, and direct-to-consumer marketing.

At a foundational level, peptides are not experimental substances. They are short chains of amino acids, essentially small proteins, …

The grief health care workers carry after maternal death

Fatemah Qasem, MD

Physician

August 31, 2026

She was a young mother.

We had never met her before. She arrived gasping for air. Within moments, the room was full. Everyone came together with one purpose, to save her. Then her heart stopped.

CPR began immediately. The obstetric team delivered the baby while compressions continued. Thirty minutes passed. No pulse. We kept going. Every voice in the room was thinking out loud. What are the reversible causes? Keep going. Don’t …

Student loans are not blocking your practice ownership

Brian Hanks, MBA, CFP

Physician Finance

August 30, 2026

Clinicians are trained to demand certainty before they act. In the operatory or the exam room, that risk-averse instinct is exactly what keeps patients safe. Applied to career decisions, the same instinct becomes one of the most expensive habits in modern health care.

There is a sentence I hear almost every week from young clinicians, and it sounds so responsible that nobody ever questions it: “I’ll think about ownership once my …

The buyer is not the user in electronic health records

Matthias Muenzer, MD

Health Technology

August 30, 2026

I have practiced medicine for more than three decades, thirty years of obstetrics and gynecology, and now addiction medicine. For seventeen of those years, I have worked inside electronic medical records that waste my time, interrupt my thinking, and stand between me and the person in front of me.

Like a lot of clinicians, I kept notebooks, running lists of what a truly helpful record would do, scribbled after long evenings …

The physician disposability nobody wants to name

Ronald L. Lindsay, MD

Physician

August 30, 2026

I am writing this from the slow, disciplined landscape of recovery (one repaired shoulder, one sling, and one unrepairable truth): Medicine did not suddenly become fragile when AI arrived. It did not suddenly become threatened when APRNs and NPs expanded their scope. It did not suddenly become replaceable in the twenty-first century.

Medicine became fragile when institutions discovered they could dispose of physicians and still call it progress.

I know this because …

Medical infographics now look right without being right

Shaan R. Mody

Medical Education

August 30, 2026

I recently found myself doing something almost every medical student has done before a presentation: searching online for a diagram that could explain a complex concept more clearly than words alone.

What surprised me was not the number of infographics available. It was how difficult it had become to determine who created them, where the information came from, or whether the content had been reviewed by anyone with medical expertise.

In the …

The hidden payment gap crushing independent physicians

Kayvan Haddadan, MD

Physician

August 30, 2026

The health care system is supposed to put the patient first. Physicians evaluate, diagnose, treat, and manage risk. Hospitals, insurers, administrators, and regulators exist to support that clinical relationship and not to displace it.

Yet the current structure of American medicine produces the opposite outcome. Patients face longer waits and higher barriers. Independent physicians confront declining real reimbursement and mounting administrative demands. Practices are acquired by health systems. Physicians spend more …

What do best states to practice medicine rankings miss?

Arthur Lazarus, MD, MBA

Physician

August 30, 2026

An excerpt from Essays and Echoes: Reflections from a Life in Medicine.

Every year, someone ranks the best states in which to practice medicine, presumably because physicians have been unable to make major life decisions without consulting a color-coded map.

The 2026 WalletHub survey evaluates all 50 states and Washington, D.C., across 19 measures, including physician wages, malpractice costs, hospital availability, projected competition, and burnout. Montana ranked first, New York …

Lindsay Clancy trial: intrusive thoughts versus psychosis

Zane Kaleem, MD and Dallas Hamlin, MD

Conditions and Diseases

August 30, 2026

The Lindsay Clancy trial has raised a popular concern surrounding the notion of mothers having “intrusive thoughts” after delivery, specifically dangerous ones that, as in this case, may even be related to the murders of Lindsay Clancy’s three young children. However, “intrusive thoughts” are common after delivery and show up in many different ways in psychiatry, most of which are not dangerous. For example, one common and very scary …

The true meaning of compassion in health care

Sheryl J. Nicholson, MPH, MDiv

Conditions and Diseases

August 30, 2026

The most profound lessons in compassion did not come from textbooks or training. They came from the patients who invited me into their stories.

“Will you stay for a little while?”

A patient asked me this question after receiving news that would change the course of her life. I had no medical solution to offer. I could not take away her fear or change her diagnosis. All I could do was pull …

Food is medicine programs need infrastructure to work

Shiv K. Goel, MD

Conditions and Diseases

August 29, 2026

I’d asked whether she was eating a lot of salt. Third admission in a year, I was going down her med list, and the question wasn’t on the list. It came out sideways, the way things do at the end of a long afternoon.

Same as regular. Like everyone.

Two grams a day is what I’d told her. First visit, second visit, printed on both after-visit summaries. She nodded each time. I …

Why a shrinking brain survived a deadly brain bleed

Barbara Lazio, MD

Conditions and Diseases

August 29, 2026

An excerpt from Off the Top of My Head: Stories from the Operating Room That Will Make You Laugh (or Cry).

“She has a size six head and a size four brain,” said my chief resident, Robert. “It saved her life.”

I was a junior resident at Shock Trauma and had called Robert in to see an 80ish-year-old patient named Hilda who had a large traumatic brain hemorrhage after a car …

Frontier AI oversight must match real-world risk

Rao M. Uppu, PhD

Health Technology

August 29, 2026

Should frontier AI be allowed to grade its own homework?

In a recent Science editorial, Thorsten Holz makes an important point: Claims about the capabilities and safety of frontier AI should not rest solely on assurances from the laboratories developing these systems. Some degree of independent verification is reasonable. The more difficult question is how much oversight is justified by the evidence. Comparisons are increasingly being made between frontier AI …

Why a 20-year-old needed a full set of dentures

Sai Charan Pasupulet, DMD

Conditions and Diseases

August 29, 2026

I fitted a 20-year-old for a full set of dentures last year.

Not implants. Not a partial. A complete set, top and bottom, the kind I was trained to expect on patients in their seventies. By the time he sat in my chair, there was nothing left to save. Years of untreated decay had worked through enamel, then dentin, then the roots themselves, one tooth at a time, until removal was …

Care orchestration should start in the patient portal

Anne Baskakova, MBA

Conditions and Diseases

August 29, 2026

After years of working with numerous health systems and my own experiences as a patient and caregiver, I have come to realize how challenging it can be to manage one’s own care. Care doesn’t stop when patients leave a health care facility. It is often just the beginning of a long journey for them. Most often, after a doctor visit or surgical procedure, a patient has an extensive to-do list: …

4 questions to ask before you trust clinical AI tools

Neil Panchal, DO

Health Technology

August 29, 2026

A colleague showed me a tool she was thinking about bringing into her practice. She pasted in a patient summary and got back a tidy set of next steps. Ten minutes later, to show me how it worked, she pasted the same summary in again. The answer came back different. The gap was small, but if the two of us had been covering for each other that week, we would …

Punishing a suicide attempt teaches people to hide it

Timothy Lesaca, MD

Conditions and Diseases

August 29, 2026

On August 3, a nineteen-year-old sailor went overboard from the aircraft carrier USS Abraham Lincoln. Rescuers pulled him from the water and took him for medical care. According to his wife, he was attempting to die by suicide. The Navy has not confirmed this, but news reports say charging documents accuse him of malingering under Article 83 of the Uniform Code of Military Justice and being absent without leave under …

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