“Doctor, it’s not my portion. I don’t have hypertension,” she said confidently, shifting her wrapper and returning my gaze like I had just accused her of something terrible.
The blood pressure monitor read 170/120 mmHg. I had just measured it myself twice, yet here I was, facing a patient who flat-out refused to believe her numbers.
She was a middle-aged woman who came in complaining of a headache and body weakness. She …
Imagine a family physician who works 12-hour days packed with complex cases and endless paperwork. They may skip meals, miss their child’s recital, and stay late to finish charting. Patient care feels rushed, and the physician begins to feel emotionally numb and irritable. Driving home exhausted, the doctor wonders if medicine was the right career choice! A physician’s role is considered a calling, and when it starts to feel like …
It is a question that has stopped more than a few of my physician clients in their tracks: Who are you outside of the white coat?
I do not mean your hobbies, though yes, of course those matter. I mean your identity. Your core sense of self when you strip away the pager, the patient lists, the provider ID, and even the deeply ingrained instincts to care, to fix, to achieve. …
Medical errors happen every day, and patients are being harmed in hospitals. Despite years of tracking and reporting outcome-based quality measures, preventable harm remains widespread, prompting the Centers for Medicare & Medicaid Services (CMS) to launch the Patient Safety Structural Measure (PSSM). This measure, released in August 2024, focuses on structural and cultural root causes of harm rather than just retrospective results of quality improvement initiatives.
In our consultancy practice, we’re …
For decades, you were told that whole milk was the devil in a glass. Doctors (including me), dietitians, and public health agencies told you to toss the red cap and grab the blue — skim, 1 percent, or 2 percent milk. Why? Because whole milk had fat. And fat, particularly saturated fat, was supposed to clog your arteries like grease in a kitchen drain.
Except we were wrong.
The fat in whole …
About a month ago, I developed a very sudden and alarming skin condition—clusters of painful, itchy bumps that quickly spread across my arms, legs, and chest. At first, I was not overly worried. I made an appointment with my primary care physician, expecting answers. But the exam was brief—she took a cursory glance and speculated it was an allergic reaction. To her credit, she didn’t jump to conclusions. She snapped …
As nurse practitioners, our professional licenses are more than credentials. They are symbols of trust, responsibility, and commitment. It is vital we never take them for granted, because when they are compromised, not only do we suffer, but our entire profession pays the price.
We must be vigilant: Safeguarding our licenses is on us alone
No one cares about our NP licenses as much as we do. They grant us the privilege …
An excerpt from Crave: The Hidden Biology of Addiction and Cancer.
Prevention, as commonly understood, has struggled to match the evolving reality of cancer. The traditional model rests on two main ideas: Reducing exposure to known carcinogens and detecting abnormalities as early as possible. Avoid tobacco, wear sunscreen, and get screened. These recommendations remain useful, yet they are incomplete. They overlook the terrain in which disease develops. They address threats …
Physicians joining private practices have a relatively new issue they should be aware of. As more practices are taken over by private equity, the traditional concerns of a physician joining a practice as an employee with the hope of becoming an owner are heightened.
Traditionally, the physician would join the practice as an employee, work for a few years, and get the “golden ring” of ownership after a few years. Often …
This story has been fictionalized.
Dorothy Klein. MRN 508291987. DOB 12/22/1962. Patient A-. Unit A-. Unit number W038306745014-K.
OK. Next.
Dorothy Klein. MRN 508291987. DOB 12/22/1962. Patient A-. Unit A-. Unit number W038306928906-K.
We finish checking the emergency release blood and wait. We know that whatever was coming up isn’t going to be pretty. A lung transplant gone bad, uncontrolled hemorrhaging, 14 hours on the table. So much blood transfused, an exploratory laparotomy was …
Although cardiovascular disease (CVD) is the world’s largest cause of mortality, its burden varies by ethnicity. People from South Asia, including Bangladesh, Sri Lanka, Nepal, India, and Pakistan, are among the groups most at risk for developing coronary artery disease too soon. However, this population frequently receives standard risk assessments in clinical practice across the U.S. that do not take ethnic-specific risk factors into consideration, which results in underdiagnosis and …
At age 81, I am one of “the old guys” who writes in online chronic pain support groups. I get a lot of emails from people in pain. One recent inquiry was from a lady named Marisa, who asked questions that are combined in the title of this article. The following is my response to Marisa and others.
My wife is a chronic pain patient who has multiple medical issues. I …
The first thing I remember is the sound of oxygen at night.
It was my second week as a hospice nurse. I had just pulled up to a modest home on a cul-de-sac, the kind of place where wind chimes echo off empty sidewalks. Inside, a man in his seventies was dying of end-stage pulmonary fibrosis. He was surrounded by family, but it was that soft hiss—steady and rhythmic, like an …
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I remember a patient in her early sixties who came to our clinic with subtle memory problems. She lived alone in a rural county, relied on Medicaid, and had been passed between social services and different primary care providers for more than a year. No one had ordered imaging, and there were no neurologists nearby. By the time Alzheimer’s disease was suspected, her window for early intervention had already closed.
Medicare …
Everyone deserves informed, compassionate and respectful health care. As medical professionals, we have the profound privilege and responsibility to make a difference in the lives of others.
As a practicing Board Certified Plastic Surgeon in San Francisco, CA, I have dedicated my practice to serving trans women, trans men, non-binary and gender-diverse individuals. Through this practice, I have viewed discrimination at the most basic levels. Patients struggle to find primary care …
We are now waiting for sentencing in the Sean (P. Diddy) Combs trial. Onlookers reading about the trial could have various thoughts. Thoughts about how power corrupts behavior. Thoughts about how men manipulate women through violence and sex. There could be schadenfreude. There could be prurience. Me, I think about HIV preexposure prophylaxis (PrEP).
You heard correctly, PrEP. When I hear testimony about multiple partners and escorts, my concern is for …
A recent surge in misleading ads and AI-generated videos on social media and other online sites promoting bogus diabetes products, treatments and cures – often using fake endorsements, including from my organization Diabetes Canada – poses a serious health risk to people living with diabetes.
So far this year, Diabetes Canada has heard from at least 300 people who saw or bought fake products like smart watches claiming to non-invasively …
This past week, an unhinged man in Atlanta committed an atrocity. He went to the Centers for Disease Control (CDC) with five guns and killed a policeman. He blamed the COVID-19 vaccine for making him depressed and suicidal, and it is reported that he had been reaching out for mental health assistance for weeks.
Since January 2022, I have been interacting with national experts on a clinical problem that has hit …
Colorectal cancer (CRC) is the second-deadliest cancer in the U.S.; however, screening rates remain too low due to a combination of lack of awareness, patient fear, and health care system barriers. Many patients don’t realize they are at risk because early-stage CRC has no symptoms, making screening the only way to detect and prevent disease progression.
As frontline health care providers, nurse practitioners (NPs) and physician associates/assistants (PAs) are uniquely positioned …
In the late 1970s, a Japanese biochemist named Akira Endo discovered a compound from fungus that inhibited HMG-CoA reductase, the enzyme responsible for making cholesterol. It was an academic curiosity at the time. No one knew if lowering cholesterol would prevent heart attacks—it just lowered a number on a lab slip.
That compound eventually became lovastatin, and in 1987, Merck brought it to market with no proof of improved outcomes—only a …
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