Physician

The physical exam in the AI era

Jason Ryan, MD

Physician

January 2, 2026

For decades, many have documented the decline of the physical exam. As imaging grew more powerful, labs more precise, and algorithms more accurate, the stethoscope and reflex hammer faded in importance. Some even speculated that technology would eventually make hands-on diagnostic skills obsolete.

But the next era of medicine may flip that prediction on its head.

Picture a future where artificial intelligence participates in nearly all patient management decisions. This seems inevitable …

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The physical exam in the AI era

Physician attrition rates rise: the hidden crisis in health care

Arthur Lazarus, MD, MBA

Physician

January 2, 2026

America’s physician shortage is no longer a distant projection. It is happening now, steadily, one resignation, early retirement, and practice closure at a time.

A nationwide, longitudinal analysis published in Annals of Internal Medicine tracked more than 712,000 physicians caring for Medicare patients over a decade and found a troubling trend: Physician attrition from clinical practice rose from 3.5 percent in 2013 to 4.9 percent in 2019, across every specialty, …

How frivolous lawsuits drive up health care costs

Howard Smith, MD

Physician

January 2, 2026

Frivolous medical malpractice lawsuits are endemic and infect everyone whether they realize it or not. The greed of plaintiffs, attorneys, medical experts, and malpractice carriers, coupled with the ineptitude of the tort system, causes avoidable costs. Everyone pays the price.

Some plaintiffs sue for medical malpractice just because they harbor a grievance against a doctor and their claim has no attributable merit. Plaintiff attorneys, who are looking for business, advertise …

The shifting meaning of supervision in modern health care

Timothy Lesaca, MD

Physician

January 2, 2026

The discomfort I felt around supervising did not arise in the clinic. It arose while reading the agreements meant to define it.

Supervisory agreements. Collaborative designations. Regulatory language that needed to be reconciled (carefully, deliberately) because names, roles, and obligations matter. Like many physicians, I have signed these documents countless times. But reading them slowly, rather than reflexively, produced an unexpected unease, one that felt structural rather than personal.

The language was …

Personalized scientific communication: the patient experience

Dr. Vivek Podder

Physician

January 1, 2026

For decades, medicine has spoken the language of hazard ratios, Kaplan-Meier curves, and median survival differences. We have become fluent in the grammar of precision oncology, genomic signatures, driver mutations, targeted therapeutics, and real-time disease monitoring. But there is one language we have not yet mastered: the language of the patient’s lived experience.

Personalized medicine cannot stop at matching the right drug to the right tumor. It must also include personalized …

From law to medicine: Witnessing trauma on the Pacific Coast Highway

Scott Ellner, DO, MPH

Physician

January 1, 2026

An excerpt from Wipe Out, Rise Up: A Surf Session In Being a Leader, Pushing Past Limits, and Sustaining Health. Copyright © 2024 Scott Ellner. Published by BrightRay Publishing. All rights reserved.

Growing up in Southern California, I was well-acquainted with the waves of the Pacific Ocean. Cold water from Alaska flowed down the coast, meeting the warm, sunny climate of Los Angeles, roasted by the heat of the Santa …

Why doctors struggle with treating friends and family

Rebecca Margolis, DO and Alyson Axelrod, DO

Physician

January 1, 2026

Early in medical school, a professor warned us: “Never prescribe for someone who isn’t your patient.” He shared a story of writing a simple antibiotic for a friend who later developed Stevens-Johnson syndrome, a devastating outcome that haunted him long after. His message was clear: There is a bright line between caring and causing harm.

Fifteen years out, we now understand just how blurry that line really is.

“First, do no harm” …

A simple nocturia management technique for seniors

Neil R. M. Buist, MD

Physician

December 31, 2025

As a 93-year-old physician, I am well acquainted with the ravages of aging and the continuous adaptations we all must make to accommodate its increasing demands. One area that is particularly troublesome is nocturia with repeated, late-night calls to the toilet. This is not only an issue of disturbed sleep, but also of safety. Nocturia involves leaving my bed, turning on a light, and making my way to the bathroom, …

Lessons on leadership from a Navy surgeon and NFL doctor

David B. Mandell, JD, MBA

Physician

December 31, 2025

In a valuable episode of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, spoke with Dr. Matthew Provencher, an orthopedic surgeon, Navy veteran, former team physician for the New England Patriots and Boston Red Sox, and current partner at The Steadman Clinic in Vail, Colorado. Dr. Provencher’s story spans small-town roots, elite military service, academic medicine, professional sports, and entrepreneurial ventures. His journey offers physicians …

Sjogren’s, fibromyalgia, and the weight of invisible illness

Dr. Bodhibrata Banerjee

Physician

December 31, 2025

Some illnesses do not storm the body to the brink of death. They don’t show up in emergency rooms or leave dramatic scans behind. Yet they quietly hollow a life from the inside, stealing ease, stealing spontaneity, turning ordinary days into endurance tests. Autoimmune disease and chronic pain often live in that space: not terminal, but relentless; not fatal, yet capable of dimming the world so deeply that survival becomes …

When racism findings challenge institutional narratives

Anonymous

Physician

December 31, 2025

In the annals of social science, few imperatives are more solemnly intoned than the necessity of measuring racism with the cold precision that only quantification can provide. Only when bias is reduced to p-values and effect sizes may one confidently proclaim, “Behold, the incontrovertible evidence of racism,” secure in the knowledge that no reasonable interlocutor can wriggle free on the strength of anecdote or wounded sentiment. Yet such measurements, to …

5 things health care must stop doing to improve physician well-being

Christie Mulholland, MD

Physician

December 29, 2025

I direct a Faculty Well-being Champions Program overseeing 47 physician champions across 33 departments. I also practice palliative care part-time and coach physicians navigating burnout. I liaise with well-being leaders nationwide, some at programs just checking a wellness box, others genuinely trying to get it right. This year taught me that well-being work reveals patterns. The same destructive habits show up across institutions, specialties, and conversations.

As 2025 closes, here are …

Why patient trust in physicians is declining

Mansi Kotwal, MD, MPH

Physician

December 29, 2025

My last patient of the day had been to four other doctors before coming to see me. She was coming in for abdominal pain that had been going on for about two years and had seen multiple specialists that resulted in multiple tests, in hopes to get an explanation for her symptoms. She came in wanting answers, but also skeptical of me. Skeptical of my ability to help her, skeptical …

Mindfulness in the journey: Finding rewards in the middle

Diane W. Shannon, MD, MPH

Physician

December 29, 2025

I recently returned from a truly magical trip to Iceland. While there, my husband and I hiked, ate wonderful food, and soaked in a different culture.

On day five of six, we ventured out to find what was described as a “hot springs river,” a body of water fed equally by glacier melt and geothermal hot springs. As a floating enthusiast, this was a must-see for me.

We hiked for an hour, …

Moral dilemmas in medicine: Why some problems have no solutions

Patrick Hudson, MD

Physician

December 28, 2025

Every now and then I go back to a book I read decades ago. Sometimes it feels dated, a period piece. Sometimes it sounds uncannily current, as if it has been waiting. And sometimes it does both at once, which is more unsettling.

Recently I reread Moral Dilemmas in Medicine, first published in 1975. I read it as a younger physician, still believing that if you learned enough and tried …

Physician non-compete clauses: a barrier to patient access

Sharisse Stephenson, MD, MBA

Physician

December 28, 2025

Patients rarely see the contracts behind their care, but physicians feel them every day. And one contract clause in particular (the non-compete) is quietly worsening the physician shortage and blocking patients from seeing the very doctors who want to care for them.

I learned this firsthand.

After serving as a neurologist and EEG medical director in Portsmouth, Virginia, I was forced out of my role under a two-year non-compete. The restriction forbids …

Restoring clinical judgment through medical education reform

Anonymous

Physician

December 28, 2025

A modest proposal for the reform of American medicine might begin, improbably enough, in a suburban pediatrician’s office where, last week, a physician of evident earnestness instructed my adolescent son to sleep until noon whenever possible, on the theory that tardy rising is the royal road to superior intelligence. The authority cited was a single paper (published, with all due respect, in the journal Personality and Individual Differences) bearing the …

Why I left pediatric cardiology: a story of moral injury

Susan MacLellan-Tobert, MD

Physician

December 27, 2025

I retired from my pediatric cardiology practice almost two years ago, and I keep circling back to one of the final days of my career. For a long time, I told myself I had simply burned out, worn thin by the pace and the paperwork. Only with time and reflection have I realized I didn’t step away because I was tired, I stepped away because of deep moral injury.

I remember …

Home for Christmas: a physician’s tale of prior authorization

Edward Anselm, MD

Physician

December 27, 2025

It was Christmas Eve 2005, and the health plan was closing at 3 p.m. By 4 p.m., the nurses, doctors, pharmacists, and support staff who handled utilization management for HIP Health Plan were already on their way home. My usual role at the health insurance company involved creating quality profiles for physicians caring for our roughly 1 million members. But that afternoon, I was covering hospital admissions so colleagues could …

Why current medical malpractice tort reforms fail

Howard Smith, MD

Physician

December 27, 2025

It is beyond a doubt that, in many states, including the state of Maryland in which I am licensed, tort reforms for medical malpractice occupy a good part of the legislative agenda. In Maryland, tort reforms bring:

Caps: The cap on noneconomic damages is first set at $650,000, and increases by $15,000 each year. Medical malpractice has a separate cap structure; however, the cap is $905,000. There must be an …
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Why current medical malpractice tort reforms fail

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