Physician

Pediatrician vs. grandmother: Choosing love over medical advice

Physician
December 23, 2025

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. …

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How I got Dr. Luis Torres Díaz on Wikipedia: a grandson’s journey

Physician
December 23, 2025

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 …

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Direct primary care vs psychotherapy models: Why they aren’t interchangeable

Physician
December 23, 2025

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 …

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The hidden depth of the rural primary care shortage

Physician
December 23, 2025

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 …

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Preventing physician burnout: an educational approach

Physician
December 23, 2025

The frequency and severity of physician burnout have resulted in an epidemic that is impairing the American health care delivery system. Herbert Freudenberger coined the term burnout in 1977, referring to a syndrome characterized by emotional exhaustion, depersonalization or cynicism, and a lack of personal accomplishment. He noted that burnout reduced health care workers’ ability to provide excellent patient care and adversely affected their well-being.

Physician burnout is rampant in the …

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Physician grief and patient loss: Navigating the emotional toll of medicine

Physician
December 20, 2025

“Doc, I’ve seen enough doctors. I only trust you. I want you to do my knee replacement and fix my heart.”

I heard the conviction in his voice when I heard these words from this patient. Sitting across from me was a 76-year-old army veteran I had cared for over two decades. He had seen multiple specialists, endured countless consultations, and, in the end, he wanted me, the physician who had …

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Is primary care becoming a triage station?

Physician
December 19, 2025

Let’s discuss primary care. That’s primary care, as in P-R-I-M-A-R-Y C-A-R-E.

Why the emphasis?

  • Because I believe high-quality primary care is the bedrock of a well-functioning health care system.
  • Because I believe access to primary care is a marker of a healthy nation.
  • Because I believe quality primary care can save lives, extend lifespan and healthspan, and importantly:
  • Because I believe quality primary care can reduce health care costs.

Sadly, I don’t …

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Violence against physicians and the role of empathy

Physician
December 19, 2025

It was past 7 p.m. when I finally reached home after another long day in the outpatient oncology clinic. My mind still echoed with the day’s stories: patients fighting pain, families clinging to hope, and the small victories that made the exhaustion feel almost worthwhile. There was emotional fatigue, but also peace.

Then I opened WhatsApp. The headline jolted me: “Doctor in Chennai stabbed by patient’s son after mother’s death.” He …

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Finding meaning in medicine through the lens of Scarlet Begonias

Physician
December 18, 2025

“Once in a while you get shown the light
In the strangest of places if you look at it right.”

That line from Scarlet Begonias (lyrics by Robert Hunter, melody by Jerry Garcia) has followed generations like a benediction disguised as a song lyric. Released in 1974 on the Grateful Dead album From the Mars Hotel, it has become something more than poetry. It is a philosophy of attention, a reminder that …

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Profit vs. patients in the U.S. health care system

Physician
December 18, 2025

Illness is inevitable, and medical care can be expensive. The U.S. is the only developed nation without some form of universal health care. Instead, it relies on a for-profit system in which insurance companies often seek ways to reduce costs, sometimes by delaying or denying coverage for services. These delays can include requirements such as prior authorization or peer-to-peer reviews for standard, guideline-directed treatments. This process takes up health care …

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Why medicine needs military-style leadership and reconnaissance

Physician
December 18, 2025

Robert E. Lee did not lose Gettysburg because he lacked courage or troops. He lost because he was blind. His cavalry commander, J.E.B. Stuart, galloped off on his own, leaving Lee without reconnaissance. By the time Stuart returned, George Custer cut him to pieces. Leadership without recon is leadership without eyes.

Screening tests are the point in a military formation. They provide the initial lay of the land. In medicine, they …

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Psychiatrists are physicians: a key distinction

Physician
December 17, 2025

A new patient recently told me, “I’ve already seen two doctors about this.” She meant a life coach with an online certificate and a therapist with a doctorate in education. Neither was a physician. Neither had examined her, ordered labs, or considered medical causes for her rapid cognitive decline.

When I evaluated her, it was immediately clear she needed urgent neurological workup. She wasn’t suffering from “stress.” She had an early …

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Why we can’t forget public health

Physician
December 16, 2025

Standing in the middle of the parking lot of the Berkeley 2000 Recreation Center in February 2021, Molly Humphreys, in a single frame, captures an important moment in the public’s collective health, though it can be easily missed if we don’t pause and absorb its significance. In the chaos of 2025, it would be careless to not linger on this image.

A masked …

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Why pediatric leadership fails without logistics and tactics

Physician
December 16, 2025

In my previous critiques of the failure of the American Academy of Pediatrics (AAP), the American Board of Pediatrics (ABP), and the Society for Developmental and Behavioral Pediatrics (SDBP) titled “Why developmental and behavioral pediatrics faces a recruitment collapse,” I argued that “leadership presence without leadership action is theater.” The SDBP strategy had no actionable items.

Any military historian will tell you that in addition to an overall strategy, you …

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The emotional toll of trauma care

Physician
December 15, 2025

I work as an emergency physician in the emergency department at a Level 1 trauma center. Because time is of the essence, when we get a trauma into the ED, they are automatically deemed a Doe – John or Jane. Due to the number of traumas we see at our trauma center in a given year, another word gets added to the Doe to make them easier to identify. It …

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Physician leadership communication tips

Physician
December 14, 2025

Let’s be honest. Most frontline clinicians don’t wake up worrying about CDC updates. They’re worrying about whether the ED has enough staff, or whether the patient they discharge will receive the follow-up care they need.

So when another vaccine recommendation or public policy update drops, often contradicting the last, it’s no wonder people roll their eyes. The problem isn’t that clinicians don’t care about public health; it’s that the messaging often …

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Why developmental and behavioral pediatrics faces a recruitment collapse

Physician
December 14, 2025

For two months I have staged testimony, written op-eds, and amplified coalition voices about the collapse of developmental and behavioral pediatrics (DBP). This piece is an epilogue, a reckoning with a specialty that once held promise but now clings to aspirational posters instead of actionable reform.

The poster problem

The Society for Developmental and Behavioral Pediatrics (SDBP) recently circulated a flyer titled Critical Outcomes in DBP. Page 2 lists “Solutions” to the …

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Valuing non-procedural physician skills

Physician
December 14, 2025

No matter the specialty, the best doctors make it look effortless and “easy.” Whether it’s suturing a jagged laceration, reading an MRI spine with multi-level degeneration, or delivering a ten-pound baby with shoulder dystocia, the most skilled physicians can handle it without breaking a sweat. But we know it took many years of training, proficiency, feedback, and improvement to master their craft.

I’m not going to argue that surgical procedures are …

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The life of a physician on call

Physician
December 13, 2025

The moon was full, the stars shone bright
I thought I’d settle down for the night
Upon my soft pillow my head got caught
Until a phone call stirred me from my foolish thought

On Friday night of weekend call
One patient had refused it all
When Pit was offered, she said, “No way!”
Internals too were brushed away.

We waited calmly, full of grace
For natural labor to take its place

And sure enough, on Sunday’s eve
After a day …

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Why physician business literacy matters

Physician
December 13, 2025

Most physicians practicing medicine today were trained to diagnose and treat patients, not to navigate one of the most complex industries in the world, an industry characterized by ever-changing payer contracts, evolving reimbursement structures, complex and sometimes mystifying coding, and challenging operational realities. Despite the lack of training, these same physicians and providers are leading multimillion-dollar businesses and are expected by their health systems to reduce costs, improve outcomes, and …

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