Physician

How prior authorization and step therapy harm pain management

Physician

April 1, 2026

Imagine a 54-year-old construction worker named Mike living with debilitating chronic lower back pain after years on the job. His doctor recommends a targeted epidural steroid injection and a short course of physical therapy combined with a non-opioid medication that has helped many patients in similar situations regain function and avoid surgery. But the insurance company says no. First, Mike must try cheaper generic pain pills that barely touch his …

Pajama time is for fools

Armand Rodriguez, MD

Physician

April 1, 2026

I really tried to have AI come up with an innocuous-sounding title for this piece: “Caring Hearts, Lighter Wallets: The Financial Reality of Primary Care.” But my poor judgment prevailed so I just decided to insult all of my colleagues right from the start. I assure you, for better or worse, that this article is my original opinion although with AI editing for grammar and clarity (but unfortunately not brevity). …

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Pajama time is for fools

Overcoming physician burnout with a new care model

Jerina Gani, MD, MPH

Physician

April 1, 2026

Many physicians do not talk about this openly, but at some point in their careers, a quiet question begins to surface: Is this really what it is supposed to feel like? After years, often decades, of training, sacrifice, and dedication, all of us as primary care physicians find ourselves in a position that, on paper, looks successful. We are caring for thousands of patients, maintaining full schedules, and carrying immense …

How ethical dilemmas in medicine affect body donation

Francisco M. Torres, MD

Physician

April 1, 2026

Many clinicians recall cases that stand out not for their diagnostic complexity, but for their ethical dilemmas. One such experience involved a long-time patient, a devout Catholic in his 70s, who asked if donating his body to science conflicted with his church’s teachings.

For years, I have displayed a favorite prayer on a poster in my office called “Prayer of the Catholic Physician.” This display gave my patient the opening to …

Finding purpose as an international medical graduate in the U.K.

Dr. Afsar Ashraf and Dr. Amal Pulikkal

Physician

April 1, 2026

The second time I landed in the U.K., the dream felt different. My first trip was for an exam; this time, it was for good. I walked into the arrivals hall with two bags. One was a worn suitcase packed with stethoscopes and textbooks. The other was invisible but far heavier, filled with my parents’ hopes and my wife’s unwavering faith.

In the bustling chaos of the international boarding area, after …

Global health security and WHO: Why U.S. withdrawal is dangerous

Adeel Khan, MD

Physician

March 31, 2026

In an increasingly globalized world, pathogens travel faster than ever before. Commercial aviation connects remote villages to major metropolitan hubs in less than a day. Supply chains stretch across continents. Climate change is expanding the geographic range of disease-carrying animals and insects. Against this backdrop, the decision by the United States to withdraw from the World Health Organization (WHO) is not merely short-sighted, it is strategically misguided and frankly dangerous.

Global …

How to find reliable online health information and avoid medical misinformation

M. Bennet Broner, PhD

Physician

March 31, 2026

Previously, I urged readers to use the internet for information about health conditions, medications, and other medical concerns to help make informed decisions about their care. I must modify this based on an online search experience I had that yielded mostly garbage. If I had not known what to seek, I would have been confused, ended my search prematurely, as I expect most people would have, and learned nothing.

To simplify …

Overcoming resource constraints in American medicine

Brooke Buckley, MD, MBA

Physician

March 31, 2026

For much of modern American medicine, we operated with an unspoken assumption: Resources would expand to meet demand. If complexity grew, we added specialists. If volume increased, we built. If margins tightened, we layered new reimbursement strategies. That operating model now feels more like an illusion.

Workforce shortages, supply chain instability, climate disruption, and rising costs have made constraint structural rather than episodic. We are practicing in a globally interdependent system …

Why we need a new medical specialty to fix corporate medicine

Allan Dobzyniak, MD

Physician

March 31, 2026

Perhaps the time has arrived to view the clinical practice of medicine differently. The practitioners are now broadly identified either as primary care providers or specialists. Specialty care is more easily defined, but whether such care is used appropriately is another question.

Primary care now includes pediatrics, internal medicine, and family practice with an increasing number of physician extenders, nurse practitioners, and physician assistants. Primary care has transitioned into something quite …

The hidden costs of diffuse accountability in medical teams

Gus W. Krucke, MD

Physician

March 30, 2026

I have watched the scope-of-practice debate for decades, from call rooms and crowded wards, from intensive care units and emergency departments, and from the deafening quiet that follows a code well run yet not won.

Early in my career, I argued the way many physicians do, with outcome data and workforce projections. Over time, I came to see that those arguments skirt the deeper question: When clinical authority expands, does accountability …

Overcoming moral injury in medicine: a Doctor’s Day reflection

Seleipiri Akobo, MD, MPH, MBA

Physician

March 30, 2026

The white coat has always been a symbol of a sacred trust, a commitment to “do no harm.” But as we approach Doctor’s Day 2026, many of us find ourselves grappling with a different kind of harm. It is not a physical wound, nor is it the “burnout” often cited in corporate wellness modules. It is the moral injury of us.

In our daily practice, we increasingly find ourselves at the …

Why resilience is not the cure for physician burnout

Lisa Rubiano, DO

Physician

March 30, 2026

When I think about the defining trait physicians have, it is perseverance. Persistence in doing something despite difficulty or delay in achieving success. We work hard to get into medical school. If you do not get accepted the first time, you double down. You apply to more schools, take a course for the MCAT, brush up on interview skills, and pad your resume with more research. You explore less traditional …

Finding meaning in medicine: Reconnecting with your childhood calling

Brian Sayers, MD

Physician

March 30, 2026

If you are a child of the 1960s, chances are your mother or grandmother made some of your clothes from scratch. They would go to a fabric store, look through the hundreds of small packets of printed sewing patterns, and select their next project. The patterns were sheets of thin tissue paper containing outlines of how the fabric should be cut, with instructions on how to piece them together. My …

The dysfunctional medical malpractice marketplace and tort reform

Howard Smith, MD

Physician

March 29, 2026

Nationwide, 200,000 lawsuits are filed per year. Among them are between 66,000 and 85,000 medical malpractice cases; however, this number is uncertain. Between 22,000 and 44,000 of these culminate favorably for the plaintiff as a settlement or a verdict. The remainder, two-thirds of all malpractice claims, are dropped or otherwise end favorably for the defendant. These statistics suggest that many medical malpractice claims are frivolous yet are still represented, and …

The cost of time constraints in primary care: Why doctors feel rushed

Ann Lebeck, MD

Physician

March 29, 2026

A patient comes in with hip pain. It is not dramatic hip pain. There is no trauma and no fall. It is just a gradual ache that now wakes her up at night. She cannot sit comfortably. Getting in and out of the car is harder, and she is worried. The X-ray is normal. Now what?

In another era, this is where medicine began, not ended. It began with history, examination, …

Avicenna’s influence on modern medicine: a physician’s reflection

Farid Sabet-Sharghi, MD

Physician

March 29, 2026

In the modern-day world, a physician’s daily routine is often a whirlwind of clinical data, digital notifications, and the latest diagnostic protocols. Yet, in the quiet moments between patients, I find myself returning to the teachings of a man who lived over a millennium ago: Ibn Sina, known to history as Avicenna.

While we often view the history of medicine as a linear climb from “darkness” to “enlightenment,” the Canon of …

How high taxes and the California Medical Board fuel the physician shortage

Kayvan Haddadan, MD

Physician

March 28, 2026

Picture this. You finish another long day caring for patients who need you. You head home exhausted but fulfilled. Then the worry creeps in. Will another complaint land on your desk tomorrow? Will your take-home pay cover the mortgage in this state? You love California. You trained here. You built your life here. Yet more and more of us are scanning job postings in Texas, Florida, or Arizona, not because …

Why physician burnout is actually a loss of professional identity

Timothy Lesaca, MD

Physician

March 28, 2026

Most accounts of physician burnout begin with a familiar list: too many hours, too many clicks, too many patients, and not enough time. The diagnosis follows easily. Doctors are exhausted. Something inside them has been used up. Burned out. That explanation has the advantage of being familiar. It also has the potential to be incomplete. There is another way to understand what is happening, one that comes from an unlikely …

Night shift weight loss: a practical fasting guide for physicians

Aaron Grubner, MD

Physician

March 27, 2026

Working the night shift is brutal. Circadian rhythms are disrupted, backup help in true emergencies is limited, and even simple things like labs or imaging can take far longer than they should. But one of the biggest challenges is late-night snacking.

There is something about the combination of darkness, fatigue, and intermittent slow periods that makes it ridiculously easy to inhale a two-pound bag of potato chips without thinking twice. Research …

The death of medical swagger: How physician status has changed

Paul Dranichnikov, MD, PhD

Physician

March 27, 2026

Fifty years ago, being a doctor was like being a cross between a wizard and a rock star. People would whisper in awe when you walked by: “There goes Dr. High-and-Mighty, saving lives and curing everything from a runny nose to a broken heart!” My dad used to tell me stories about how he would get waved past security, cut to the front of lines, score doctor discounts, and park …

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