Physician

Shared responsibility in patient care needs boundaries

Physician

April 30, 2026

At the end of a visit, it is common to say: “Call if things get worse.” It sounds supportive. It sounds open-ended. It sounds safe. But what does “worse” mean? More frequent pain? More intense pain? Pain that wakes the patient at night? Pain that interferes with work? Without definition, responsibility shifts quietly.

Modern care depends on patients, not simply to follow instructions, but to understand the treatment plan, to carry …

The cost of chaos in medical malpractice litigation

Howard Smith, MD

Physician

April 29, 2026

If anything represents the economic effects of medical malpractice, it is the following two cases. One involves a teenage mother and a major academic medical center. According to attorneys on both sides, the lawsuit is legitimate. However, its underlying merit is described as only 25.3 percent. Nevertheless, a legal strategy obscures this. The mother is 16 years old when she conceives and lives in a West African country until 17 …

Doctors leave California over a tilted legal system

Kayvan Haddadan, MD

Physician

April 29, 2026

As a practicing pain management physician in good standing in California, I’ve observed how accusations against physicians are actively encouraged, while meaningful accountability for false or exaggerated claims is largely ignored. This creates a system that rewards a “throw mud until something sticks” strategy for financial gain by patients, insurers, and other parties. This is precisely why I wrote the book Legal Mind in Medicine to highlight the legal …

Integrity in medicine is quietly under strain

Patrick Hudson, MD

Physician

April 29, 2026

There is a sentence physicians have said for generations: “We’ll take good care of you.” It is a good sentence. Patients need to hear it, and most of the time it is said with sincerity. Yet there are moments, more now than before, when that sentence carries a second awareness alongside it. The emergency department is boarding. There may not be an inpatient bed for hours, sometimes longer. Tests, consults, …

How to negotiate a physician sabbatical in private practice

Sarah Gebauer, MD

Physician

April 29, 2026

When I tell other physicians that I negotiated a sabbatical from private practice, a full semester abroad with my family, followed by months of extended travel, the reaction is almost always the same. It starts with disbelief, moves quickly to calculation (“But who covered you? What happened to your income?”), and ends, more often than not, with a version of: “I could never do that.” I understand the reaction because …

Why patient understanding is the missing metric in medicine

Joseph A. Rotella, MD, DC

Physician

April 28, 2026

A patient nods. You explain the diagnosis. You review the plan. You answer questions. You feel like the visit went well.

“Any questions?” you ask.

“No, I am good.”

They leave. And if you are honest, there is a moment, sometimes fleeting, sometimes not, where you wonder: Did they actually understand any of that? As you know, you have to pick up the pace to see another patient. In modern medicine, we measure …

Pilot mental health is a safety issue, not a stigma

Timothy Lesaca, MD

Physician

April 28, 2026

You know what it feels like to keep working and pushing yourself when you are tired, distracted, or maybe even burned out. It’s common across professions, and we rarely speak about it openly. We almost never think of it as a safety issue. But for airline pilots, that silence can put hundreds of lives at risk.

That is why I believe this belongs in a conversation among clinicians. Medicine is often …

How corporate health care ruined the medical profession

Edmond Cabbabe, MD

Physician

April 27, 2026

In the golden days of practicing medicine, the hospitals’ boards were composed of community leaders acting on behalf of the hospitals to raise funds, negotiate insurance contracts, screen and supervise the performance of the key employees, and interact with the government. They used their passion and influence to facilitate the delivery of health care to the communities they served. Most of these board members were volunteers or philanthropists. A few …

The true crime community is radicalizing kids online

Dexter Ingram & Matthew Turner, MD & Stephen Sandelich, MD

Physician

April 26, 2026

As physicians who regularly work with pediatric patients, and experts in counter-terrorism, we know firsthand the dangers that online radicalization poses to youth. Nihilistic violent extremism (NVE), which glorifies violence for the sake of violence, is on the rise globally. Many of these decentralized online networks, such as the 764 Network, specifically target children for recruitment. 764 has seen a sharp increase in popularity, and has become the …

Navigating medical training and residency as a female plastic surgeon

Smita Ramanadham, MD

Physician

April 26, 2026

An excerpt from The DNA of a Doctor: How Upbringing, Culture, and Unbridled Ambition Curates Achievement.

Having the support of male colleagues and mentors was not new to me. I could not have gotten through plastic surgery residency without my male co-residents. Being the only woman in my class and the classes I was sandwiched between could be daunting. My male co-residents were a blessing, they looked after me, and …

13.1 reasons running a half marathon beats practicing medicine

John Wei, MD

Physician

April 25, 2026

This past weekend, I completed the United Airlines NYC Half Marathon, a 13.1-mile course running across the Brooklyn Bridge, through the streets of New York, through Times Square and Central Park, finally finishing upright and with both shoes still on. In the 48 hours since crossing the line, I have reflected deeply on the experience and arrived at one inescapable conclusion: It was still better than going to work. Please …

Why experiential consent is replacing traditional medical consent forms

Ron Tongbai, MD

Physician

April 23, 2026

Imagine sitting in a witness box while a plaintiff attorney holds up your drafted, 15th-grade surgical consent form. You know the patient signed it. You know you spent 10 minutes explaining the risks. But then the attorney asks the patient: “When the doctor warned you about positive dysphotopsia, did you know it meant you wouldn’t be able to drive your grandchildren home at night?” The patient cries. The jury glares …

Why career pivots are a valid path in medical training

Whitney Black, MD

Physician

April 23, 2026

The medical students I work with are already starting to close doors. They are in their twenties, still in training, and they are already narrowing, already deciding which parts of themselves fit inside the life they are building toward. I recognize it because I did the same thing. I just did not realize it until much later. And no one told me there was another way to look at it. …

Why early detection technology and precision medicine are failing patients

Julie Chen, MD

Physician

April 23, 2026

The tools to detect serious disease years before symptoms appear already exist. What we are waiting on is a health care system structured to use them. Early in my career in primary care, I watched patients with vague symptoms and normal lab results get dismissed as anxious or mildly depressed. While some were, others were experiencing the very earliest stages of disease. Signals that more advanced diagnostics would have caught, …

Physician autonomy is not separate from patient care

Corinne Sundar Rao, MD

Physician

April 22, 2026

Recently, I came across the Charter of the Soignés (“those being cared for”) by French physician and writer Martin Winckler from The School of Caregivers (2019).

This is not a legal document, but an ethical framework. It outlines 10 principles centered on dignity, autonomy, and the humanity of the patient.

The first nine principles focus on what we would hope our patients experience. The recognition that a person is more than a …

Bridging the gap between a chronic disease diagnosis and treatment

Donald Kushner, MD

Physician

April 21, 2026

Early in my career, I saved a man’s life, and he was not pleased. Mr. H came to see me for knee pain. With my training still fresh, I moved through a standard review of systems. When I asked about cardiac symptoms, he mentioned that for several weeks, walking more than a block caused chest pain that resolved with rest. The knee was forgotten. I explained the cardiac risk, ordered …

When shared decision making gives way to medical paternalism

DeAnna Pollock, MD

Physician

April 21, 2026

“Why haven’t they scheduled your dad for his feeding tube placement? They just want another family conference.” I sighed and told my mother we may have to fight. The physicians caring for my father seemed ready to overrule her decision, even though she held his medical power of attorney. When I spoke with an intern, I explained that our family had not changed our mind about the course of treatment. …

Medical expert testimony vs. advocacy in the courtroom

Howard Smith, MD

Physician

April 20, 2026

In Opinions, which is section 9.7.1 of the American Medical Association (AMA) Code of Medical Ethics, a physician serving as an expert witness has a duty to act as an objective, independent professional whose opinions are based on science, and not act as an advocate whose opinions win lawsuits. The question, which I now raise, is: “Are opinions expressed by a medical expert, which have 95 percent confidence (the …

Leaving clinical practice for medical advocacy and purpose

Ronald L. Lindsay, MD

Physician

April 20, 2026

Two days after Christmas, I walked into a store and saw Easter Cadbury Eggs already on the shelves. Not a single mattress sale for Presidents’ Day in sight. Just a clean leap from tinsel to tulips, as if the world had quietly decided to skip the expected steps and sprint ahead. It struck me because that is exactly what my life feels like right now. For decades, I lived inside …

Trusting clinical intuition to spot an atypical heart attack

Anonymous

Physician

April 19, 2026

An excerpt from Those Shoes: A Physician’s Reckoning with Life, Death and the Medical Machine.

The nurse caught me before I walked in the room, “This next patient says he knows you.” I looked in the room and saw Jim, the gate guard in my neighborhood. “What’s he here for?” “Back pain,” she said, with a look I recognized. “You know what he wants.” I knew what she meant. Back …

Physician

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