Physician

The enduring value of the physical exam in modern medicine

Physician

February 26, 2026

I recall the moment I fully grasped the critical importance of the physical exam and how easily it can be overlooked, often with serious consequences.

Early in my fellowship, an elderly patient was referred to our team with an apparently straightforward case of sciatica. His MRI revealed a disc herniation at L5/S1 with foraminal narrowing, prompting discussion about whether an epidural injection or surgery would be more beneficial. I was tasked …

Health care price transparency: Why patients are bypassing insurance

Sally Daganzo, MD

Physician

February 26, 2026

I recently went to Quest Diagnostics for a TB test and a couple of basic labs my doctor ordered. At check-in, I recalled my insurance had changed in the new year and I did not have the updated information readily available. I did not have time to reschedule nor sort it out so figured I could pay cash and reconcile it later. That seemed reasonable, if inconvenient.

When I asked what …

The ticking clock: How time constraints in medicine hurt patient care

Timothy Lesaca, MD

Physician

February 25, 2026

We are taught to watch for conflicts of interest in the form of pharmaceutical pens and consulting checks, yet we often overlook the most pervasive corruption of all: the ticking of the clock.

We traditionally describe medical conflicts of interest in corporate terms: free dinners, speaking fees, and consulting arrangements. These temptations are real, and they deserve the scrutiny and rules we apply to them. But they are external distractions. The …

“The only thing that will change will be our name”: a private equity cautionary tale

Anonymous

Physician

February 25, 2026

“The only thing that will change will be our name.”

These were the words shared by a senior partner when our staff was informed that the partnership had decided to sell the practice to a private equity firm. Unfortunately, as the story unfolded, that was also the moment that my future changed.

I was an associate when those now infamous words were uttered. While I was wary of this transition, it was …

Leadership in action: How a broken pager fixed a hospital

Ronald L. Lindsay, MD

Physician

February 24, 2026

Sometimes, the smallest failures expose the largest truths. At a remote Air Force base hospital, a silent pager revealed not my incompetence, but my supervisor’s lack of leadership, and set in motion a chain of events that reshaped the hospital’s command structure and ultimately influenced the future of Air Force pediatrics.

What began as a malfunction during an award ceremony became the catalyst for decisive leadership, a reorganization of medical services, …

Profits before patients: the hidden cost of U.S. health care

Dr. Shantanu Rai

Physician

February 24, 2026

If you want to understand what “profits before patients” means in American health care, don’t start with a spreadsheet. Start with a story.

During residency, I cared for a middle-aged mother of two who came to our community hospital emergency room struggling to breathe. It didn’t take long to realize she needed something we couldn’t offer: urgent heart surgery at a larger hospital.

After a 30-hour shift, I filed the transfer request …

Why maintenance of certification varies widely: a system in crisis

Brian Hudes, MD

Physician

February 24, 2026

If you asked ten physicians to explain how they maintain board certification, you’d get at least ten different answers, maybe more. Some take quarterly quizzes. Some submit CME attestations every five years. Some do both. Others, grandfathered in before time-limited certification existed, do nothing at all. Yet every one of them carries the same professional label: board-certified physician.

That simple title, once synonymous with competence, now hides a dizzying patchwork of …

AI governance in health care: Why physicians must lead the design

Tod Stillson, MD

Physician

February 23, 2026

Artificial intelligence is no longer approaching medicine. It is already embedded inside it. It drafts our notes. It summarizes research. It suggests differentials. It triages messages. It promises efficiency, scale, and relief from burnout. Physicians are adopting it quickly. That speed should give us pause.

The greatest threat facing physicians in 2026 is not resisting artificial intelligence. It is allowing artificial intelligence in health care to be designed without us. Every …

Surgical practice efficiency: How to fix a broken system

Paul Toomey, MD

Physician

February 23, 2026

For years, patients did not complain about their surgical care. They complained about not getting calls back.

The frustrating part was that my staff was calling them back. Messages were left. Voicemails filled up. Phone trees were in place. And still, patients felt ignored, staff felt defensive, and I found myself on a constant apology tour.

I assumed this was just how modern medical offices worked.

We had three people answering phones. We …

Future of AI in medicine: Will algorithms replace doctors?

Patrick Hudson, MD

Physician

February 22, 2026

I recently wrote a four-part series examining AI and the future of medicine. The response confirmed something important. Physicians are not merely curious about artificial intelligence. They are unsettled. The headlines are loud. Automation. Disruption. Replacement. It is reasonable to ask whether doctors will lose jobs, whether surgeons will be replaced, whether this is the beginning of a profession fundamentally reshaped.

The answers are neither triumphalist nor catastrophic. AI replaces tasks. …

The hidden cost of medical board regulation and prosecutorial overreach

Kayvan Haddadan, MD

Physician

February 22, 2026

Close your eyes and imagine a health care system that truly prioritizes patients above all else, one that is free from political interference, financial incentives, or secondary gains that distort decision-making. In this ideal framework, regulatory bodies such as the Medical Board, Centers for Disease Control and Prevention (CDC), and Drug Enforcement Administration (DEA) would enforce guidelines uniformly and based on evidence, without inadvertently inflating costs or compromising care quality …

Agentic AI: the key to saving annual preventive exams

Sara Pastoor, MD

Physician

February 21, 2026

Annual preventive exams have been a staple of American medicine for decades. Yet despite their importance, preventive visits remain underutilized in American health care, which is no surprise in a system that centers sick care and incentivizes churning out services instead of improving outcomes.

In fact, only 60% of Medicare beneficiaries complete their annual well visits, and less than 65% of children under 19 complete their well-child check-ups. When …

Reviewing locum tenens agreements: Look beyond the hourly rate

Sriman Swarup, MD, MBA

Physician

February 20, 2026

I was halfway through reviewing what looked like an excellent locums opportunity when I realized the hourly rate was the least important number in the agreement. The compensation was strong. The schedule was flexible. Travel was covered. On the surface, it seemed straightforward.

But what ultimately determined whether the opportunity made sense had very little to do with pay. It had to do with clarity.

The difference between conversations and contracts

Locums conversations …

Physician burnout: Finding peace in a broken health care system

Jessica Singh, MD

Physician

February 20, 2026

Among the people exiting the hospital, I could easily pick out the medical staff leaving their shifts. It wasn’t by their clothing or the time of day, but by the unspoken language of relief on their faces: a calm twinkle in the eyes or a gentle softness around the forehead and jaw. Dawn or dusk, the look was always there. I hoped I’d have it too when I left later …

Understanding the 4 models of health care: Where the U.S. fits

Howard Smith, MD

Physician

February 19, 2026

We are frequently told that our health care system is expensive. However, most of us, including physicians, have no notion about what the health care system really is, to judge whether or not we are getting our money’s worth.

There are four major structural models for a health care system:

The Beveridge model (socialized medicine): Health care is provided and financed by the government through tax payments (e.g., United Kingdom’s NHS).

…

What got you here won’t get you there: a physician’s guide to leadership

Harvey Castro, MD, MBA

Physician

February 19, 2026

You became a physician because you were driven. You studied longer, pushed harder, and tolerated pressure better than most. You needed to be right and usually were. That formula worked. It got you through pre-med, medical school, residency, and into practice. It earned you respect and built your reputation.

But at some point, quietly, subtly, that same formula can start working against you. I realized this after reading Marshall Goldsmith’s book, …

The 3-2-1 method: a doctor’s guide to keeping New Year’s resolutions

Anthony Fleg, MD

Physician

February 19, 2026

Welcome to the first weeks of the new year. A great moment to check in.

How are you doing? How are you feeling? Energy level?

The first days of the new year come with a lot of excitement and a lot of pressure.

Excitement for the sense of renewal and becoming better versions of ourselves. Excitement in putting the last year to rest and starting with a clean slate. Excitement at putting down …

Learning from patients: How a physician gained strength and resilience

Samantha Fernandes, MD

Physician

February 19, 2026

I remember. It is a gorgeous summer day as the sunlight streaks through the redwood canopy. My grip clenches the dangling rope. My stance wobbles on the itty-bitty circular disk. I am uncertain. Teeter-tottering, I plot my next move. It does not happen. I plummet. My harness transforms into a bucket swing, saving me from the forest floor. I sway in the pleasant breeze. I cannot finish the Level 1 …

Rural emergency medicine in New Mexico: a physician’s firsthand account

Sarah Bridge, MD

Physician

February 18, 2026

Recently, I was asked to write about my experience as a rural emergency physician in New Mexico. The timing was uncanny: I am in the final shifts of my first job out of my emergency medicine residency on the East Coast, having spent more than four years working in emergency departments across western rural New Mexico, primarily within the Indian Health Service.

Summarizing this experience concisely feels impossible. Every emergency physician …

What the folinic acid retraction means for autism treatment

Timothy Lesaca, MD

Physician

February 17, 2026

On January 29, 2026, the European Journal of Pediatrics formally retracted what had been the largest randomized clinical trial examining folinic acid as an intervention for autism. The reason, according to the journal’s notice, was direct: The study’s data did not support its published conclusions.

Originally released in 2024, the trial reported that 24 weeks of oral folinic acid therapy produced a “significant reduction” in autism symptoms among 77 children. In …

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