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President and chief executive officer of the National Psoriasis Foundation (NPF) Leah M. Howard discusses her article “Pharmacy benefit manager reform vs. direct drug plans.” Leah analyzes the recent emergence of direct-purchase …
A vacant expression covered the face of a 14-year-old boy who lay almost lifeless in a hospital bed, completely unaware of the frantic hustle that surrounded him. Once an extraordinary student-athlete, intracerebral hemorrhage unjustly robbed him of his robust character. This was my most significant interaction with a patient. I knew him not as the student-athlete, nor the boy from neurosurgery, but as my youngest brother. With limited access to …
“Turn on, tune in, drop out” was a rallying cry for liberation. “What a long, strange trip it’s been” is how we nostalgically narrate the aftermath. Psychedelic-assisted therapy now sits somewhere between those two cultural bookends: a rapidly professionalizing clinical enterprise and a booming, loosely regulated marketplace of “retreats” selling healing, insight, and transcendence.
The science behind psychedelics is more real than ever. So are the risks. The problem is …
Imagine a cancer therapy that bypasses the immune system and strikes tumors with greater precision. The advantages of a blindfolded immune system could mean reduced therapeutic side effects and delivering more of the drug to where it is needed the most. Now imagine that this potentially safer and highly effective therapy was available on demand. Thanks to a new generation of genetically modified biologics, it may be closer than we …
Artificial intelligence (AI) is rapidly entering clinical spaces, and ChatGPT is among the tools drawing increasing interest. Hospitals recognize their potential to reduce administrative burden, improve communication, and support clinical decision-making.
But with this potential comes responsibility. Deploying large language models (LLMs) in health care without proper oversight can lead to misinformation, privacy breaches, and erosion of patient trust. Before implementation, hospitals must establish a framework grounded in safety, ethics, and …
In caring for patients with chronic illness, we often assume that if people truly understood the consequences of poor disease management, they would change. We explain complications, cite lab values, outline risks, and sometimes lean into fear in hopes that it will motivate action. When patients do not follow recommendations, we label them as noncompliant or unmotivated. Yet chronic illness is not managed in exam rooms or hospital beds. It …
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Premedical student Samah Khan discusses her article “The crisis of physician shortages globally.” Samah draws a powerful parallel between the medical exodus in Pakistan and the doctor deserts of California’s Central Valley, …
“If you ask what they like about their surgeon and they only say they are nice? I don’t want a nice person.” This sentiment comes from Dr. Oz, a boarded and licensed thoracic surgeon, and was posed to the house of medicine at the 2025 House of Delegates Interim Meeting.
I have grappled with what being a good surgeon means to me. Our training would have us believe that a good …
The American Board of Internal Medicine (ABIM) made headlines in late 2024 when it announced the elimination of its unpopular two-year Maintenance of Certification (MOC) point requirement. On paper, this looked like progress, a gesture toward simplification after years of criticism from physicians who felt trapped in an expensive, time-consuming cycle that added little value to their actual practice. But beneath the surface, the reform raises a harder question: Has …
Scrotal pain in young men is a frequent reason for emergency department visits and urology consultations. While many underlying causes are benign and self-limiting, others, most notably testicular torsion, represent true urologic emergencies in which delayed intervention can result in irreversible testicular damage.
The clinical challenge lies in distinguishing conditions that allow for short-term observation from those requiring immediate evaluation. This distinction is particularly important in adolescents and young adults, …
Canada prides itself on having a strong public health system, yet we continue to treat oral health as optional. Dental disease occupies a peculiar niche in health care: scientifically essential, yet structurally marginalized. We know that chronic gum inflammation is linked to heart disease, stroke, diabetes complications, and even adverse pregnancy outcomes. Yet it remains largely detached from how we think about preventing chronic illness.
This disconnect isn’t caused by a …
For many older adults living alone, a smartphone is not a convenience. It is a lifeline.
In elder care meetings, we often discuss telemedicine, wearable sensors, and remote monitoring systems. We focus on dashboards and data. Yet in our pursuit of high-tech solutions, we frequently overlook the most widely used and emotionally loaded digital tool already resting in older adults’ hands: the messaging app.
In Taiwan, as in much of Asia, LINE …
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Most recognize me for extolling the virtues of deductive reasoning in medical malpractice case review, but I never explain why I am so worked up over medical malpractice. Some would point out, “There are only 17,000 malpractice lawsuits filed per year out of a total of perhaps as many as 40 million lawsuits filed nationwide. Therefore, medical malpractice represents 0.04 percent of all lawsuits filed. What’s the big deal?” …
As of January 1, 2026, the American health care system is in crisis. People can no longer afford their health insurance premiums or even to afford to pay for any health insurance. Recently, a 62-year-old self-employed friend of mine saw his premiums increased tenfold in a single cycle. I am lucky that I am over 65 and have Medicare insurance as well as a pension from my employment. Millions of …
An excerpt from What the Physician Whispered.
You are looking at me, little one,
perhaps wondering who I might be.
Even though I might seem friendly,
you seem wary and frightened, not yet
used to seeing strangers and busy places.
Someone thought maybe I might help save you.
I offer to give you poison.
They have not told you, because they do not know
how sick you really are, meaning how close you are
to an unexpected conclusion that …
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Health care executive Jason Griffin discusses his article “The digital divide in rural health care.” Jason explains how rural providers in the U.S. face critical infrastructure failures and staffing shortages that threaten …
The use of MRI body scanning as a preventative tool was highlighted by the president’s recent rope-a-dope with the media. Community practice whole-body MRI businesses now exist, local entrepreneurs directly marketing these services to the public. These scans are not reimbursable by traditional health payers.
The attraction of MRI is its lack of ionizing radiation, as well as its proven sensitivity to a variety of pathologies. Example: Detection of breast cancer …
In medicine, waiting is normalized. We’re trained in it. Praised for it. We learn to delay sleep, meals, vacations, and emotions. We delay joy. Rest. Fulfillment. Relationships. Children.
From the very beginning, we’re taught that waiting is a virtue. That endurance is professionalism. That sacrificing our own needs is a sign of how much we care.
During training, we wait (for sleep, for food, for recognition). We wait for the pager to …
By 11 p.m., my clinic was dark but my brain wasn’t. I found myself scrolling through my schedule for the next day: 22 patient visits, a pile of unsigned notes, two meetings squeezed into “lunch,” and a post-call morning that somehow still started at 7 a.m. None of these tasks were unusual, but what struck me was the growing tightness in my chest and the realization that I had quietly …
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