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General surgeon Arthur Williams discusses his article “A surgeon’s battle with ketamine-induced hallucinations.” He shares an account from his novel of an experience needing a pacemaker for a “janky heart” prone to …
A surgeon’s startling ketamine experience [PODCAST]
In the previous article, I offered four ways (other than growth) a practice can compensate for declining reimbursements: improve efficiency, boost collection ratio, increase productivity, and consider a practice merger. As promised, here are four more.
Stay focused.
Focused strategies lead to better outcomes and lower costs. It is no accident that the best outcomes and lowest price for open-heart surgery are achieved …
How doctors can thrive despite declining reimbursements
An excerpt from Dr. Koop: The Many Lives of the Surgeon General.
“I’ve had two major messages that I’ve tried to get out to the public all my professional life,” Koop proclaimed. “One is to take charge of your own health. The other is that there is no prescription I can give you that is more valuable than knowledge … I’ve tried the non-profit world, …
How DrKoop.com rose and fell: the untold story behind the Surgeon General’s startup
I absolutely hate prescribing medication to children.
I am quite worried when someone asks for my opinion on a sick child. I have some experience treating children during my internship and residency, yet I am pretty uncomfortable.
However, living in a lower middle-income country, where the average man already lives a difficult life due to high health care costs and limited income, health expenditure significantly impacts monthly finances. That is why people …
Why prescribing medicine to kids scares even experienced doctors
For years, empathy has been seen as a moral virtue that binds relationships, the antidote to pain and suffering while caring for patients. But lately, empathy is facing a surprising backlash in society and the medical profession. From being called “toxic” to being labeled outright as a “sin,” the virtue of feeling others’ pain is now under sharper scrutiny across ideological, psychological, and even religious groups within our society.
In caregiving …
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Internal medicine and infectious disease physician and author Joshua D. Hartzell discusses his article “Leading with care: How health care leadership can transform patient and provider well-being.” He addresses the crisis of …
Leading with care: a new approach to health care leadership for well-being [PODCAST]
If I had a dollar for every time I’ve typed out a broken heart emoji in response to yet another tragedy, I’d probably be able to take a break from work for a while. But here I am—because I love what I do despite it all.
There are many days my heart breaks.
Not in the cliché, romance-gone-wrong kind of way. It’s deeper than that. It’s …
Calling for a heart surgeon: a plea for change
A chilling incident from a past summer camp at Achimota School still resonates: A young woman collapsed with her life hanging in the balance. The male Red Cross prefect, attempting to administer potentially life-saving CPR, was quickly stopped by concerned students. The bystanders’ focus was on protecting her from exposure, and it overshadowed the urgency of the situation. This experience, now viewed through the lens of my medical training, reveals …
When modesty kills: the CPR gender gap you didn’t know existed
She was pale, underweight, fifty years old and scared. Mrs. G was a breast cancer patient on the oncology unit whom I met by chance, as she appeared on my patient census list that morning. As I walked into her room, I noticed the fragrant flowers, the cards scattered about her hospital tray, and the numerous pictures of her friends and family that attempted to bring her peace and comfort. …
Breast cancer was never supposed to be part of my story
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Surgeon and author Jeffrey A. Singer discusses his article “The FDA’s outdated prescription rules are failing women and opioid users.” He argues that the U.S. Food and Drug Administration’s requirement for prescriptions …
Why the FDA’s outdated prescription rules hinder access to birth control and naloxone [PODCAST]
Artificial intelligence (AI) large language models (LLMs) and the systems based on this technology have recently emerged onto the medical scene with huge promises to “disrupt” and innovate upon traditional clinical practice. Ignoring the hype and boom-bust adoption cycles associated with most novel technology, AI will eventually settle into the daily workflow of many physicians, be it through direct use, or indirectly, through integration within EMRs, insurance approval pipelines, or …
Medical school admissions are racing toward an AI-driven disaster
Increasingly, it’s showing up in people in their 20s and 30s—individuals who don’t drink excessively, don’t appear outwardly unhealthy, and often have no idea their liver is under stress. The condition, now referred to as metabolic dysfunction-associated steatohepatitis (MASH), is emerging as a quiet epidemic, and diet and gut health are playing a larger role than many realize.
As a gastroenterologist, I’ve observed a shift in the demographics …
Fatty liver disease is no longer reserved for older adults
The actions taken by the Medical Board against a compassionate physician dedicated to alleviating chronic pain are nothing short of egregious, deeply flawed, and emblematic of a system that seems intent on punishing rather than protecting. This esteemed doctor, who has spent years serving patients in dire need with integrity and professionalism, now finds himself ensnared by a process that appears more vindictive than just, more biased than fair.
The silent crisis hurting pain patients and their doctors
I stood at the check-in counter of my physician’s office, waiting for my yearly physical. Beside me, another patient was checking in. I recognized her instantly.
It was Denise—my childhood best friend.
And yet, I couldn’t bring myself to say hello.
We had spent our childhoods side by side—playing Barbies, cheerleading, swimming at the neighborhood pool. Every single day. She wasn’t just a friend; she was my safe place. We stayed close all …
What money can’t fix: the scars left by a friend
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Health care executive Gavin Magaha discusses his article “Advancing drug discount programs starts with collaboration and clarity.” He outlines how the 340B drug discount program, established over 30 years ago, has not …
Reforming the 340B drug discount program through data, clarity, and collaboration [PODCAST]
In recent years, psychiatric care has undergone a shift in the clinical mindset toward medication management for people living with schizophrenia and other chronic mental health conditions. As recognition grows for the breadth and depth of the clinical complexities and psychosocial challenges that patients may face along their diagnostic and treatment journey, there is movement toward ensuring that patients have access to treatment options that integrate their needs and preferences. …
Why long-acting injectables are transforming schizophrenia care
I’m in this place of noticing—not reacting—simply noticing the dance between myself and my environment, in the clinical setting and beyond.
I’m noticing myself in conversation with colleagues. I’m asking the tough questions I hadn’t thought to ask before: Do my thoughts, ideas, and opinions truly contribute to moving the conversation forward? Do they actually help shape the actions needed to reach the end result?
As physicians, we often believe they do. …
The quiet shift: Practicing presence in the fast-paced medical profession
The health, judicial, and socioeconomic disparities among ethnic minorities are pervasive, and vaccination rates are key among them. The inequities among marginalized groups are largely driven by social determinants of health, education, and access to care. The United States has a well-documented history of these inadequacies, strengthened even further by the COVID-19 pandemic in 2020, leading to higher mortality and …
Why vaccine access still fails America’s most vulnerable groups
I read with great interest the recently published article in The New York Times by Paul Tough, who has reported on child development and education over the last twenty years. He outlines statistics, specifically the rise in diagnosis of children and adults since the 1990s, and then discusses implications, including questioning a current understanding of the disorder and its treatment.
Neurodevelopmental disorder
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder …
ADHD isn’t one-size-fits-all: Why nuance in diagnosis matters
For the past 30 years, I’ve witnessed medicine evolve—new technologies emerge, new treatments are developed, and wellness programs are implemented—but one thing remains stubbornly unchanged: the relentless, often destructive, quest for validation. As I reflect on my career, I can’t help but see a parallel with the TV series Severance, where employees’ work selves—their “innies”—are literally separated from their personal lives—their “outies.” In our profession, our innie is the part …
Why chasing validation is destroying physicians’ sense of self
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