Many of the physicians I work with live with a quiet weight of imposter syndrome. They show up every day for patients, teams, and families, yet doubt their own belonging.
I wrote a short reverse poem, “Worthy in Reverse,” as a way to explore how self-talk can shape that inner experience. This poem was inspired by “Worst Day Ever?” by Chanie Gorkin, which creatively uses structure to shift perspective.
It is simple …
Two years ago, I asked, “Doctors diagnosing addiction: Are the blind leading the blind?”
The estimated rates of substance use disorder among clinical patients treated for pain vary greatly, depending on whom one believes. Studies also suffer from a widespread failure to address genetically mediated variability in minimum effective opioid dose between individuals. Thus, I have many times respectfully suggested that the entire body of literature on opioid …
Every cardiology clinic has them: patients with swollen, aching legs and bulging varicose veins. We talk about conservative management: exercise, leg elevation, and, of course, compression stockings. And almost without fail, patients smile politely, nod, and then admit at the next visit: “I couldn’t wear them. They’re too tight, too hot, too uncomfortable.”
The paradox of a simple solution
Compression stockings are one of the most effective noninvasive treatments for varicose veins …
I’ve seen clients start GLP-1 medications full of hope, and stop them feeling betrayed by their own biology. Some reached their limit with side effects: relentless nausea, fatigue, or the quiet loss of joy in eating. Others simply couldn’t afford to stay on. A few never saw the promised results at all. But for nearly all of them, the story ended the same way: one step forward, five steps back.
We …
A 2022 KevinMD article raised concerns about generic formulations of ADHD medications. The author described what many patients and families had already discovered: Not all generics are created equal. For those of us who lived through the substitutions, the difference was not abstract. It was a roller coaster that intruded on daily life, even on vacation.
The generic in question was manufactured by Mallinckrodt. Unlike Concerta, which uses an osmotic-controlled …
In May, a published report indicated that changes indicative of Alzheimer’s disease (AD) were detected at age 24 via a blood test, which is increasingly available. These changes may begin earlier, but these were the study’s youngest participants. There are no medical treatments for these early manifestations, and aside from providing knowledge of a possible future and potentially causing anxiety, what value does the test hold? Unless a person has …
I still remember the feeling of relief standing by my uncle’s bedside. The monitors were humming with steady rhythms; the surgical team was congratulating themselves on a textbook procedure. By all clinical metrics, he was a success story. The intervention worked. The pathology was addressed. He was “stable.”
We celebrated his discharge as a victory lap. We trusted that the packet of papers in his hand (filled with appointments, medication schedules, …
The National Academy of Medicine defines diagnostic error as “the failure to (a) establish an accurate and timely explanation of the patient’s health problem(s) or (b) communicate that explanation to the patient.” Office-based practices are the predominant setting for malpractice claims related to diagnostic error.
Yes, office-based care settings.
Fast-paced, high-acuity emergency departments (EDs) have fewer malpractice claims related to diagnostic error than physician offices, according to recent research. Furthermore, 53 …
Last winter, a senior nurse in our psychiatric unit told me, “The dashboard says we’re low-risk. But during night shifts, I don’t even feel safe walking to the bathroom.”
The monthly quality report on her desk said the same thing it had said for nearly a year: “Violence incidents: no significant difference among the three wards (p > .05).”
On paper, her ward looked normal. At the bedside, it was anything but.
Her …
The recent Atlantic article by Olga Khazan, “Avoiding Ultraprocessed Foods is Completely Unrealistic. Especially if you have kids,” brought a concern that I’ve carried for a long time into full clarity: Our worries about family weight and eating habits aren’t actually about the physical body. They’re about perfection. And they are a call to approach health completely differently.
I am a pediatrician working at the intersection of family stress, emotional …
A recent Wall Street Journal graphic traces the rise in autism prevalence among eight-year-olds from 2000 to 2020. The slope is unmistakable, upward, steady, and steep. But it’s not a crisis. It’s a reckoning.
Each inflection point on that chart marks a milestone in institutional clarity:
Take a look in your medicine cabinet. What you see isn’t a sign of weakness; it’s a testament to one of the greatest partnerships in modern life: the one between your body and medical science. From the vaccine you got as a kid to the pill that keeps your blood pressure in check, these interventions aren’t just treating sickness. They are part of who you are. In a world still …
Primary care innovation has always been framed around access, autonomy, burnout, and patient experience. Direct primary care (DPC) in particular is often positioned as a solution for physicians exhausted by fee-for-service complexity and for patients who want a more personal relationship with their doctor.
This article focuses on how the broader economic landscape has shifted in ways that directly affect DPC, especially in light of the rapidly evolving national discussion around …
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Most people exercise to improve cardiovascular fitness, metabolic health, or mood, but regular physical activity also plays a significant role in sexual and urinary function. As a urologist, I routinely see how movement influences two intimate yet essential systems: the reproductive system and the lower urinary tract.
When patients present with urinary leakage, erectile changes, or reduced libido, they often expect a prescription or procedure. Yet for many, measurable improvement begins …
Adapted from The Care of Foreigners: How Immigrant Physicians Changed US Healthcare. Copyright 2025. Published with permission of Johns Hopkins University Press.
In the decades following the passage of the Hart-Celler Immigration and Nationality Act of 1965, the face of American medicine irrevocably changed. This bill expedited the rapid entry of physicians from post-colonial Asian nations into the U.S. in significant numbers. In this migratory flow, South Asian physicians, in …
“The FDA has issued a nationwide recall of lisdexamfetamine capsules.”
That sentence in Newsweek magazine should have triggered alerts, guidance, and coordinated response. Instead, the silence from pediatric leadership has been deafening. Newsweek turned to the FDA and the American Academy of Family Physicians. Where are the leadership of the American Academy of Pediatrics (AAP) and the Society for Developmental and Behavioral Pediatrics? Silent. Why?
The recall that should have sparked action
In …
Some cases linger in our memory because of the humanity at their center. The case of Charlie Gard, which unfolded in England in 2017, is one of those. It took place within the National Health Service and under a legal framework in which courts decide a child’s treatment when parents and clinicians cannot agree. Before it became a global controversy, before it drew international headlines, it began as something far …
Introduction
Tay-Sachs disease is a devastating genetic disorder that primarily affects individuals of Ashkenazi Jewish descent, though it is also found among Cajuns in Louisiana and French-Canadians. This fatal condition typically manifests within the first six months of life and leads to progressive neurological deterioration, often resulting in death by age five. As medical science advances, the question arises: Should genetic testing for Tay-Sachs be mandatory for all individuals of reproductive …
Children often surprise us with the seriousness they bring to a clinic visit. Every so often, when the room feels tense, I turn to a simple question and ask what their favorite toy is. Caregivers smile, and children lean forward with the kind of excitement that only play can spark. In a moment, the atmosphere changes. The room feels lighter, the conversation easier, and the visit begins to unfold with …
All clinical trials are fueled, in part, by optimism. A trial currently underway in California is fueled by the optimism of one patient in particular, Kayvon Goodarzy.
Despite decades of effort, there has been an abject lack of new approved therapies for glioblastoma (GBM). The standard of care for this deadly brain tumor has been chemotherapy and radiation, to less-than-ideal results. But that might be changing, and it’s all thanks …
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