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Interventional physiatrist Francisco M. Torres discusses his article, “A doctor’s own prostate cancer recovery.” He shares his vulnerable story of undergoing a robot-assisted radical prostatectomy and the unexpected shame and “erosion of …
Laura, my department chair, is relentless in her enthusiasm for ambient AI systems in clinical care. Daily emails, weekly reminders, and even personal demonstrations; she’s convinced this is the future of medicine. Watching her, I can’t help but feel both admiration and unease. Her excitement is genuine, but I wonder if we’re rushing toward something we don’t fully understand.
And in many ways, she’s right. There’s a quiet joy in having …
I used to think the hardest part of building better health care was securing funding.
Then I watched the same cycle repeat itself: A promising pilot launches, early outcomes are celebrated, a report is written, and when the funding period ends, the program quietly disappears. The idea did not fail. It simply could not survive.
Nothing was wrong with the clinicians involved.
Nothing was wrong with the intention.
What was missing was a system.
Health …
Walk into a convenience store. You will see sleek bottles, gummies, shots, and powders in bright wrappers. Companies market them as calm, focus, energy, sleep, pain relief. People treat them like upgraded vitamins. They swipe a card and head home. Nobody runs a checklist on dose, interactions, tolerance, withdrawal, or contamination.
This culture runs on a simple story. Natural means safe and plant means gentle. Legal means regulated while a label …
Medicine teaches us to recognize disease, to listen for the subtle signs of pathology, to read lab values and imaging scans as if they are languages unto themselves. Yet what many of us were never taught is how to interpret the quiet, internal signals of our own humanity. We can identify cardiac murmurs with precision, but we often miss the whispers of our own exhaustion.
As physicians, we spend years mastering …
This is a work of fiction.
I directed Mrs. Powell to sit and make herself comfortable. She lowered herself into the chair at the round table in the lobby of my office slowly, her frail, 90-year-old frame eventually settling into it.
“How’s your health, Mrs. Powell?” I asked. This is how I approached most conversations in which a client asked if they could meet suddenly. Usually, it meant they had gotten some …
“The meds made me do it” has become a familiar refrain whenever psychiatric treatment intersects with tragedy. It is a phrase heavy with implication, suggesting loss of control, a sense of medical betrayal, and a system that failed at its most basic task: keeping people safe. When cases like the Nick Reiner tragedy enter the public consciousness, that phrase resurfaces almost reflexively, offering a deceptively simple explanation for something incredibly …
Linda had seen seven physicians in three years. She was on five medications. And she was exhausted, not just physically, but existentially.
“Dr. Goel,” Linda said quietly, “I’ve done everything they told me. The diets. The pills. The exercise programs. Why isn’t anything working?”
At 54, Linda was a meticulous accountant living with hypertension, type 2 diabetes, obesity, chronic fatigue, and generalized anxiety disorder. Her lab results painted a picture of metabolic …
“I’m here (cough) to pick up (cough) the steroid,” says the visibly sick patient at the pharmacy. The pharmacist tries not to breathe in too deeply to catch the contagion as she hands over the box of pills. The patient has no idea that others have nicknamed it “poison” or “the Devil’s drug,” because it’s not worth it. The risks of casually prescribing prednisone or Medrol Dosepaks for seasonal illnesses …
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Vascular surgeon Xzabia Caliste discusses her article, “The silent disease causing 400 amputations daily.” She shares the heartbreaking personal story of witnessing both her aunt and uncle lose their limbs to peripheral …
During one of my junior internships, I met a patient whose care challenged not so much my medical knowledge as my understanding of culture. Mr. L., a 20-year-old university student originally from China, presented to the clinic with complaints of low back pain. He firmly believed his back pain was caused by an “improper” posture. During our discussion aimed at clarifying this misconception, I encountered considerable resistance. After speaking with …
“Doctors need to develop resilience against burnout!”
After 20 years in medicine, every time I hear this, my jaw tightens, and my TMJ reminds me I have a very limited tolerance for nonsense.
Let’s call this what it is: not burnout, exploitation.
You cannot “resilience” your way out of systemic extraction. You cannot mindfulness your way out of an industry built on squeezing more and more labor out of you for less and …
U.S. health care, once a citadel of innovation and quality, has sadly devolved into a complex, frustrating, and frequently inaccessible system. It is so disorganized and inefficient it might not even meet the definition of a “system.” U.S. health care fails to address the needs and expectations of patients on many occasions and in many ways. For most of my career, I have considered U.S. health care the best in …
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Pediatric endocrinologist Shara Bialo discusses her article, “Why type 1 diabetes screening should be part of back-to-school.” She highlights that back-to-school visits are a critical window to screen for type 1 diabetes …
Across society, AI is being adopted at an staggering rate. In medicine in particular, AI is helping physicians analyze diagnostic tests, calculate disease risk, summarize patient history, and formulate treatment plans. Health care administrators are using AI to manage and optimize workflows. Insurance companies report that AI is improving consumer service, expediting claims, and detecting fraud. AI-assisted medical research is discovering new drugs to combat Parkinson’s, …
I am a pediatrician. I am a mother. And now, a grandmother. These identities don’t always move in harmony.
When I learned my twin granddaughters had been born at home, the physician in me reacted immediately. My mind began cataloging risks, reviewing worst-case scenarios, mentally scanning for everything that could have gone wrong.
The grandmother in me, however, was called to show up differently: with love, not fear. With presence, not panic. …
I grew up hearing stories about my grandfather, Dr. Luis Torres Díaz, the way some children hear stories about national heroes. In our family, he was one of them. He was not a war hero or political figure but a quiet, thoughtful, and brilliant scientist. My grandfather was a chemist, a poet, a professor, a dean, a museum founder, a man whose life seemed to stretch across disciplines with an …
I read Zoe Crawford’s thoughtful KevinMD essay on the limitations of direct primary care (DPC) with great interest. Her frustration as a medically complex patient navigating a fragmented health care system will resonate with anyone who has struggled to obtain timely imaging, referrals, or specialty care. As a clinician who has spent a career thinking and writing about how health systems fail both patients and physicians, I agree with …
Today I am a urologist, a cardiologist, a psychiatrist, a rheumatologist. But truly, I am a rural family medicine doctor in one of the most underserved counties in the country. And I am tired.
I do not pretend to have the depth of each specialist. What I have is necessity, a toolkit built on scarcity. Practicing medicine on an island, where specialists are rare, calendars are full for months, and visiting …
For years, hospitals have been urged to modernize. We are told to digitize workflows, optimize performance, and rely on dashboards and algorithms to improve efficiency. Much of this advice is reasonable. Medicine cannot function without systems.
But recently, while observing hospital transformation from within, I began to feel a familiar unease, one I had encountered before outside of medicine.
It reminded me of how digital platforms operate.
Platforms are not inherently unethical. They …
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