Physician

The crushing bureaucracy that’s driving independent physicians to extinction

Physician
September 9, 2025

As a board-certified neurologist in independent practice for three decades, I’ve watched the soul of medicine slowly erode, not due to a lack of compassion, skill, or science, but from a suffocating bureaucracy that has infiltrated every corner of patient care. Private practice doctors across America are being regulated, pre-certified, audited, and administratively strangled out of existence.

Each week in my office, my staff and I spend countless hours fighting with …

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Food is a universal language in medicine

Physician
September 8, 2025

“What is your favorite homemade food?” I ask each patient. Almost always, there is a smile, and the conversation takes off from there. Moms light up describing their special dishes. Patients giggle when I suggest, “Should we have your mom make some for us to share?” Younger kids look at their moms with wide eyes, wondering if it could really happen. Those moments, those faces, are priceless; and they carry …

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An IMG’s story of exclusion in U.S. residency

Physician
September 7, 2025

When I was a child, I watched a neighbor struggle after a stroke. He survived, but without rehabilitation he remained trapped in his disability, dependent on others for every task. That memory shaped my understanding of medicine: Survival alone is not enough. Patients deserve a chance to reclaim independence and dignity.

Years later, after completing medical training abroad, I came to the United States as an international medical graduate (IMG), determined …

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The 4 foundations that sustain physicians through burnout and balance

Physician
September 7, 2025

Introduction

When I first arrived in North Carolina several years ago, I thought happiness would come easily. I had completed my medical education in Nepal, was ready to serve as a physician in the U.S. health care system, and carried the excitement of new beginnings. But I learned that happiness is not automatic—especially for physicians navigating American health care while maintaining their sense of purpose.

The transition from practicing medicine in Nepal …

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Should anesthesiologists object to unnecessary procedures?

Physician
September 7, 2025

Before making the case for evolving formal fellowships for physician anesthesiologists to conscientiously and systematically object to unnecessary health care, particularly unnecessary procedures, it is worth first exploring what constitutes “necessary.” Only then can we begin to regulate what may be considered “unnecessary.” Can physician anesthesiologists lead such academic and practical regulatory efforts, even amid potential conflicts of interest inherent in their role as anesthesia care providers?

This raises several important …

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The backbone of health care is breaking

Physician
September 6, 2025

A few weeks ago, I delivered a baby in the morning and sat with a grandmother near the end of life that afternoon. I adjusted insulin for a patient I first helped quit smoking ten years ago. I counseled a teenager about to leave home for college. This is the joy of family medicine: walking with people through every stage of life. But too often, that joy is overshadowed by …

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Why doctors must ask for help before burnout escalates

Physician
September 6, 2025

“If you are reluctant to ask the way, you will be lost.”
– Malay proverb

When I was struggling with burnout during training, I did not seek help.

Even when called into the office of the revered, stately, totally intimidating chair of the department, because he had “heard I was having trouble coping.”

Nope. I saw that as a sign that I needed to do a better job of hiding my lack of coping.

When …

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Why so many patients ask for drips—and what doctors wish they knew

Physician
September 6, 2025

As a doctor working in a primary health care setting, it’s become routine, almost expected, to hear patients ask for a drip. Sometimes it’s after they’ve listed their symptoms, sometimes they say it right after walking in: “Doctor, please just give me drip.” And often, the complaints aren’t serious. It could be catarrh, a mild fever, or even plain tiredness.

At first, I didn’t understand it. I’d look at the patient’s …

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Reproductive care after Roe: Why silence is not an option

Physician
September 6, 2025

Since the fall of Roe v. Wade in 2022, the United States has been navigating a reproductive health crisis unlike anything in modern history. Now, in mid-2025, the picture is even more stark, and more urgent.

In the wake of the Dobbs decision, nearly 1 in 5 patients seeking abortion care, including care for miscarriage, have been forced to travel out of state. That is more than double the number from …

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When your identity is your job: Why it’s dangerous in medicine

Physician
September 6, 2025

In some careers, your job is not something you do; it is something you are. Medicine, acting, and politics are intimate, high-visibility professions that blur the lines between personal identity and professional role. You are not just executing a skill; you are bringing your whole self into the room, exposed and accountable.

When things are going well, that visibility can feel exhilarating. You are recognized, affirmed, even admired. Your face becomes …

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Will longevity medicine put doctors out of work?

Physician
September 5, 2025

Whenever I bring up longevity medicine among some fellow physicians, I can almost hear the unspoken objections before anyone says a word. There is a pause, a sideways look, maybe even a faint smirk. If I could translate those silent expressions into captions, they would say:

“If people stop getting sick, will not we all be out of business?”

Let us stop right there. That is like saying restaurants would all go …

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Why the doctor-patient relationship needs a redesign

Physician
September 5, 2025

The landscape of medicine is evolving—and so are the roles of those who practice it. Today, more people are searching “how are doctors changing?”, “Why doesn’t my doctor have time to listen?”, or “Can doctors coach me instead of just treating symptoms?” These questions aren’t just valid—they’re vital.

For many of us in medicine, the traditional doctor-patient relationship no longer fits the needs of modern life. We’re not just being asked …

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Imposter syndrome is not a personal failing

Physician
September 5, 2025

Imposter syndrome is not a personal failing. It is a conditioned mindset. A learned pattern. We are raised in a culture of hyper vigilance. We are taught to equate uncertainty with inadequacy. We are taught it is not OK not to know an answer. That being unsure is a failing.

We prepare relentlessly. We never let our guard down. Hypervigilance is our standard mode of operating. Self-judgment is an internal soundtrack. …

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How functional medicine fills the gaps left by conventional care

Physician
September 4, 2025

As an internist with a background in physics, I was taught to think in systems—to seek root causes, avoid assumptions, and apply data with precision. Early in my career, I practiced medicine exactly as I had been trained: Identify the diagnosis, follow the algorithm, apply evidence-based treatment. And in many cases, that worked.

But increasingly, I found myself caring for patients who didn’t fit cleanly into diagnostic boxes. Fatigue, brain fog, …

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A step‑by‑step guide to crafting meaningful research questions

Physician
September 3, 2025

An excerpt from The Clinical Research Handbook: A Practical Guide to Designing, Conducting and Publishing Clinical Research.

Research is a powerful force for change. Whether addressing global health care disparities, improving local community services, advancing technology, or exploring the frontiers of science, well-chosen research projects can solve practical problems and expand our understanding of the world. However, identifying the “right” question is often the hardest—and most critical—step in this journey.

This …

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How restrictive opioid policies worsen the crisis

Physician
September 3, 2025

The ongoing opioid crisis, claiming over 70,000 lives annually in the U.S. according to the CDC’s 2023 data, presents a perplexing scenario where regulatory bodies, in their attempt to curb misuse, have inadvertently intensified challenges for health care providers and patients. The Centers for Disease Control and Prevention (CDC) issued its 2016 guideline for prescribing opioids for chronic pain, with revisions in 2022 to address misapplications, yet these efforts have …

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The dying man who gave me flowers changed how I see care

Physician
September 2, 2025

Today for the first time, I got flowers from a grateful patient.

And I reflect on how rough the week has been, all the things that seemed impossible and insurmountable, and everything that has brought me to this point. The patient is going on hospice, he’s going to die, yet he felt that I made a significant impact that he wanted to show his gratitude. And that almost brought me to …

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How market forces fracture millennial physicians’ careers

Physician
September 1, 2025

This first decade of my career as a millennial physician is starting to look as fragmented on my CV as it has felt in reality, chasing even a modicum of the stability that the physicians of my father’s generation took for granted. Meanwhile, the chaos engendered by market forces like vertical and horizontal integration across insurance and hospital systems, private-equity-backed buyouts of physician practices and surgery centers, and now just …

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Unity in primary care: Why I believe physicians and NPs/PAs must work together toward the same goal

Physician
August 31, 2025

YouTube video

In today’s health care system, primary care is stretched thin. Patients face longer wait times, providers are burned out, and practices are under constant pressure to do more with less time in their hands. In the middle of this strain, I have noticed a troubling trend, divisions between physicians (MDs, DOs) and nurse practitioners (NPs) or physician assistants (PAs).

I strongly believe that …

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