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Research scientist Nichole Cubbage discusses her article, “The silent grief of vanishing twin syndrome: Why words matter in health care.” She explains that Vanishing Twin Syndrome (VTS), the loss of one fetus …
Acknowledging the silent grief of vanishing twin syndrome [PODCAST]
I am currently working as a senior registrar in the oncology unit of a trust hospital. We admit both oncology and hematology patients in the same ward, meaning we care for patients with solid tumors as well as those with blood cancers. Our hospital has only one oncology ward, which has ten beds. Since it is a trust hospital, most treatments are provided completely free of charge. I love working …
A doctor’s emotional struggle with a young leukemia patient
The mental health crisis clinicians face but won’t talk about this May
Ask anyone about health care reform, and you’ll likely get passionate responses. Single-payer versus market-driven. Universal coverage versus cost-containment. Clinicians, though, usually have simpler wishes: fewer hours spent charting, more time spent actually caring.
But there’s a quieter, deeper conversation that’s rarely included when we talk about health care’s problems: moral distress.
DSM-5 doesn’t name it, but moral distress is everywhere in medicine
Critical to success in the restaurant industry is the practice of preparation, referred to as mise en place, a French term meaning “putting in place.” In a culinary context, mise en place signifies preparing all utensils and ingredients before you start cooking. Mise en place is required in culinary schools and high-end restaurant kitchens.
Mise en place is a guiding principle in any field, increasing productivity and improving workflow.
Here are three …
How a restaurant principle can transform your patient care
I hated so much of medical school.
Not all of it.
I started eager,
positive and bright.
I was excited.
But I struggled to belong.
There was unwritten, informal
segregation.
Fresher’s week:
I was stoked to try out new things…
Hockey and rowing turned me away—
lack of experience.
I tried something more familiar:
Hindu society.
I was shocked—
they asked me what caste I was from.
It was even in the lecture theatre:
white rugby at the back,
serious Asians at the front,
party Asians in the middle,
cool …
The quiet segregation no one talks about in medical school
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Historian and ethicist Nigel Cameron discusses his article, “C. Everett Koop’s fearless fight against the tobacco industry,” drawn from his biography of the former U.S. surgeon general. He recounts how C. Everett …
C. Everett Koop’s defining stand against the tobacco industry [PODCAST]
In medicine, heroism is often framed in dramatic, high-stakes terms: the code blue that saves a life, the pediatric cancer patient who returns to their family disease-free, or the impossible aneurysm that is successfully clipped by the neurosurgeon. But not all heroics come with a life-altering intervention. Sometimes, the most courageous act in a physician’s day happens in a conference room, during a faculty meeting, or after rounds—when someone chooses …
Not all heroes wear capes: Sometimes they just speak up in meetings
Hypothetically, imagine you complete three years of internal medicine residency; working nights, managing complex cases, making real decisions. Then you’re told: To work in the hospital, in the in-patient setting, you must complete additional years of fellowship training.
At that point, a reasonable person might ask: Wait, what was residency for? If three years of supervised, graduated responsibility isn’t sufficient preparation, then either the residency is flawed, or the requirement is …
Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam
An excerpt from Wealth Strategies for Today’s Physician: A Multi-Media Playbook.
Physicians of all specialties are different from the average U.S. investor in several important ways. This statement reflects data in key areas that impact fundamental aspects of investing and wealth management. It is important for physicians to realize these differences because most financial news, whether in print, online, or on television, is geared to the average investor. Therefore, media …
Why physicians are unlike the “average” investor
As a health care writer and data analyst, I hear frequently from patients who are being denied safe and effective pain care due to unscientific bias on the part of U.S. health care agencies—and sometimes on the part of otherwise once-reputable medical journals. These are among millions of U.S. citizens who are now being deserted by the medical profession.
Thousands, overcome by their pain and depression, have already …
The hidden bias in how we treat chronic pain
In January 2022, the United States Medical Licensing Examination (USMLE) Step 1 transitioned to a pass/fail format, sparking debate over how best to assess physician competence in an era where medical misinformation proliferates online. Although medical students loathe any mention of exams, we cannot deny that licensing exams are an important barrier to ensure baseline knowledge, and to prevent quacks and snake-oil salesmen from harming the public. This article explores …
The origin of medical licensing exams
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Physician executive Grace E. Terrell discusses her article, “Physicians must innovate and focus on medicine’s core, not chores.” She introduces the concept of “core vs. chore,” urging health care workers to distinguish …
Focusing on medicine’s core, not administrative chores [PODCAST]
On the 20th of January 2025, President Donald Trump signed an executive order that initiated a freeze on foreign aid, including the President’s Emergency Plan for AIDS Relief (PEPFAR). This abrupt suspension of funding has triggered a global health crisis, undermining decades of progress in combating HIV/AIDS and endangering millions of lives across the globe.
PEPFAR and its global success
Launched in 2003 under …
When America sneezes, the world catches a cold: Trump’s freeze on HIV/AIDS funding
Ah, burnout! That word is used so often in medicine that it now has its own ICD-10 code.
Medical professionals are no strangers to pushing beyond exhaustion, running on fumes, and convincing ourselves that a steady IV drip of caffeine and sheer willpower is an appropriate substitute for sleep.
I should know—I lived it. I was running a busy medical practice, managing over a dozen staff …
Burnout isn’t ironclad—and neither are we
“Once it’s in your body, there’s no taking it back.”
That’s what the infusion nurse told a friend of mine after administering the injection.
She had just started a biologic medication for an autoimmune condition. Immediately, her body reacted: nausea, then hives, then a terrifying tightening of her throat. She rushed back to the clinic. The IV steroids and Benadryl may have stopped the immediate effects, …
An excerpt from From Error to Ethics: Five Essential Lessons from Teaching Clinicians in Trouble.
Clinicians must be scrupulously honest in and out of work
About 70 percent of the clinicians who attended the course had been accused of dishonest conduct. It is so common that the ‘dishonesty’ file on my computer contains eight sub-sections:
Clinicians must be scrupulously honest in and out of work
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Nurse anesthetist Christine King discusses her article, “The heartbreaking pandemic story I will never forget.” Reflecting on the COVID-19 pandemic five years later, she shares the profound impact of collective trauma through …
Pandemic reflections: a nurse anesthetist on trauma, loss, and finding hope [PODCAST]
Canadians have rallied together like never before to support each other and stand up for Canada in the face of U.S. tariffs and annexation threats.
People living with diabetes need that same spirit of solidarity around them to defeat a persistent stigma about the condition that leaves them feeling blamed, shamed, and judged.
Negative perceptions about people with diabetes are not only misplaced, but they are also harmful …
In January 2025, the International Council for Harmonisation (ICH) formally adopted the updated E6(R3) Good Clinical Practice (GCP) guidelines. Annex 1 and the revised 12 principles are already in effect. Annex 2 arrives in July. This is not just regulatory housekeeping. It is a clear message to the research world: Meaningful patient involvement is no longer aspirational. It is expected.
For decades, clinical research positioned patients as participants, …
Clinical research is evolving. Patient involvement is no longer optional.
“Will I be asleep or awake during my procedure?” This is the first question many patients ask before oral surgery. It reveals a common misconception: That anesthesia works like a light switch.
It doesn’t.
Anesthesia exists on a spectrum with multiple options that can be tailored to your specific needs, procedure type, and anxiety level.
Beyond all-or-nothing
As an oral …
The anesthesia spectrum: Guiding patients through comfort options in oral surgery
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