Walk into any independent primary care practice and ask the nurse what she did on her lunch break. There’s a good chance she’ll tell you she was on the phone with the daughter of a dementia patient, calling the dialysis center to sort out a transportation problem, or following up on the discharge med rec for the COPD patient who landed in the ED again last week. None of it …
Medicare will pay for the work your nurses already do
Health care costs continue to rise, yet the conversation about why often feels like a loop. Hospitals point to insurers. Insurers point to hospitals. Pharmacy benefit managers cite manufacturers. Manufacturers point back across the system. Meanwhile, patients are left trying to make sense of bills that feel disconnected from the care they received. In Massachusetts, often viewed as a national model for health care coverage, the average total cost of …
How cross-sector collaboratives cut health care costs
F*ck fibromyalgia? No, f*ck diagnostic bias.
I’m in pain today, so please forgive the profanity. Pain has become a constant companion for me for several years now, though some days are worse than others.
I am also a pediatrician, which means I am one of the “nice doctors” who does not curse. I have never been particularly good at following that expectation outside of the exam room.
As I lay in a hospital …
Diagnostic bias almost cost me my life
Weeks after a FiercePharma webinar told drug reps to make the lab worker their first sales point and not the patient’s doctor (to avoid a delay in “therapy adoption”), the three-day Fierce Pharma Engage conference in San Diego unveiled more aggressive, stealth sales tactics.
At the well-funded meet-and-greet with 700 well-turned-out attendees, 150 speakers, and 56 corporate sponsors, we learned that:
1. AI will take over interactions with doctors (HCPs)
Whether …
3 new pharma marketing tactics every physician should know
Most conversations about failure in health care begin in the same place: What went wrong? A patient safety event. A staffing collapse. A breakdown in communication. A system failure that appears, at first glance, to be sudden and unexpected. But what if the more important question is not what went wrong, but what was already known?
Health care does not suffer from a lack of awareness. The signals are there: rising …
Why health care accountability demands system readiness
Most of the time in my work as a financial planner, my job is to help fellow physicians think long-game so they can craft a sustainable career and life they love. Today is different. We are going to focus on the short game and introduce a financial concept I call the “Courage Fund.” If you are hoping to create a more flexible career, and you cannot wait years …
Unlocking career flexibility with a Courage Fund
Ask most physicians when perimenopause begins and they will point to the menstrual cycle: irregular periods, shortened cycles, the first hints of hormonal flux. Ask most women and they will say the same. We have built an entire cultural narrative around the period as the harbinger. But for a significant number of women, perimenopause announces itself first at 3 a.m. Not with a hot flash. Not with missed bleeding. With …
Why perimenopause insomnia hurts metabolic health
Two of my recent teaching topics with medical students have been people taking medical advice from social media and the rise of “wild births,” where babies receive no medical care whatsoever. Then I opened one of my Facebook moms’ groups and saw a pregnant woman post that her baby’s genetic screening came back positive for Turner syndrome. Immediately, strangers in the comments started telling her to abort. Not physicians. Not …
Social media told her to abort her Turner syndrome baby
I am a heart transplant recipient. I understand the responsibility that comes with the organ I was given. I take my medications exactly as prescribed. I go to my appointments. I monitor for anything that could signal a problem. I do everything I am supposed to do. And I still almost ran out of my transplant medication.
What I was not prepared for was having to fight to get the medication …
Prior authorization delays vital transplant medication
We were on a call recently with a physician who told us, almost in passing, that she’d been seeing patients on a telemedicine platform for four years. She said it the way you’d mention a hobby. Then she added, before we could say anything, that of course it was just a side gig.
She’d been doing it for four years. It was her practice.
We’ve had some version of that conversation hundreds …
Telemedicine as a career, not a side gig
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A federal agency recognized food allergy as a disability, then limited boarding protection to one allergen category. Lianne Mandelbaum, a leading advocate for airline safety measures to protect food-allergic passengers, returns to explain …
DOT ruling protects peanut allergies but not eggs, sesame, or milk [PODCAST]
A physician receives the letter. It is short, formal, and absolute. A complaint has been filed. An investigation is underway. In that moment, something shifts. Not just professionally, but personally. The identity built over years of training, sacrifice, and responsibility suddenly feels fragile. Every decision, every note, every outcome is now seen through a different lens. What follows is rarely discussed. Not in training. Not in hospital corridors. Not even …
How a medical investigation drives physician burnout
Independent physicians, particularly in rural communities, have spent years navigating a steady stream of financial cuts, rising costs, and policy instability. Over time, these pressures have forced difficult decisions: scaling back services, reducing staff, and in too many cases, closing care centers altogether.
While there has been modest, temporary relief through adjustments in the Physician Fee Schedule (PFS), it has not been enough to reverse the broader trend. Many practices remain …
How Medicare reimbursement hurts independent physicians
Patient care is getting squeezed. For years now, the Medicare Physician Fee Schedule has failed to give doctors the resources they need to keep up with rising costs and deliver high-quality care. The result is real strain on practices, especially smaller and independent ones, and growing risks for patients who rely on Medicare.
When you adjust for inflation, Medicare payment rates to physicians have dropped by about 33 percent …
Medicare physician pay has fallen 33 percent since 2001
A physician without LinkedIn in 2026 is making a business mistake, a reputation mistake, and a public health mistake.
This is no longer about keeping up with social media. It is about controlling your professional identity in a world where search results, AI summaries, recruiters, hospital leaders, journalists, patients, and even opponents look you up before they call you. LinkedIn reports more than 1.3 billion members worldwide. That makes it one …
LinkedIn for physicians is not optional in 2026
My daughter had been home sick for three days. Not the kind of sick that keeps you in bed, but the kind that lingers just enough to keep you home, well enough to be bored. She was restless, observant, and thinking. She is 10.
Her dad stayed home with her the first day. I took the second. By the third day, I went back to work. I arranged my schedule so …
How physician burnout impacts modern health care
One of the hardest parts of practicing psychiatry is that we still cannot reliably predict which medication will work for which patient.
A patient comes in struggling with depression. We choose a medication based on symptoms, history, side effect profile, family history, clinical experience, and sometimes educated guesswork. Then we wait. Sometimes the medication helps quickly. Sometimes it causes side effects. Sometimes nothing happens at all. Then we adjust, augment, switch, …
Precision psychiatry is finally catching up to medicine
Burnout among nurses and clinicians has been a prominent topic over the past decade. The combination of regulatory requirements, higher patient demands, and leaner budgets in the shadow of coronavirus disease 2019 (COVID-19) has fueled the embers that have allowed this crisis of clinician burnout to smolder.
Simultaneously, health care systems are striving to deliver better clinical results in a world where transparency in data and public reporting is the expectation. …
How psychological safety reduces clinician burnout
I graduated residency with over 100 peer-reviewed publications, an EB-1A visa for extraordinary ability in medicine, and zero understanding of how health care capital works.
Nobody taught me what a term sheet was. Nobody explained how venture capital flowed into the companies building the devices, drugs, and software I used on patients every day. Nobody mentioned that the same analytical rigor I applied to systematic reviews, defining a question, evaluating evidence, …
Physicians belong in health care venture capital
Before treating a patient, you review their history, run diagnostics, and verify every detail. Have you done the same before trusting your financial advisor with your wealth?
Most medical professionals do not know if their advisor is truly acting in their best interest, or what they are really paying in fees, conflicts of interest, and hidden incentives.
I spent years working with financial advisors managing $20 million to more than $3 billion …
15 financial advisor questions for medical professionals
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