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Psychotherapist and patient advocate Sara Rands discusses her article “Early-onset breast cancer: a survivor’s story.” Sara shares her harrowing journey of finding a lump at age 32 despite having no family history …
Early detection fails when screening guidelines ignore young women [PODCAST]
I want to make something clear from the very beginning, because this point often gets lost when taking this perspective on this topic.
Nurses, physician assistants, occupational therapists, physical therapists, medical assistants, and every allied-health professional are indispensable to our health care system. They are professionals whose expertise saves lives, keeps clinics running, and provides the continuity of care that physicians alone cannot sustain. Their work is rigorous, their training is …
Student loan cuts for health professionals
As a physician-psychiatrist, I have watched the rise of GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound) with genuine admiration. They are transforming metabolic health, reducing cardiovascular risk, and offering hope to patients who have struggled for decades. For many, these medications are lifesaving.
But alongside the excitement, I’m witnessing something rarely discussed: a change in personality and affect, especially at higher doses.
This pattern reminds me of the early days of SSRIs. When …
GLP-1 psychological side effects: a psychiatrist’s view
A laboratory transport truck crashed in Mississippi last month resulting in eight monkeys escaping, seven of whom were shot and killed after surviving the initial crash. Tragedies like this happen too often. Over the past two decades, there have been more than 15 publicly reported lab monkey escapes, both during transportation and directly from labs, including from the California, Southwest, and Oregon National Primate Research …
Why lab monkey escapes demand transparency
Most people assume that pain and illness are caused only by injury or disease. If your back hurts, it must be damaged; abdominal pain must come only from inflammation, infection, or tumor. Most physicians learn this in medical school, as I did. But treatment based on this assumption often fails to provide relief for persistent pain, leaving millions of patients and countless well-intentioned physicians frustrated and in despair. The result …
Emotional awareness and expression therapy explained
An excerpt from My Eight Year Kidney Stone Journey.
In the fifth year of my kidney stone battle, after yet another painful episode, I reached a turning point. I remember recovering at home, sipping the bland herbal tea I had switched to (since I was even worried regular tea might have too much oxalate), and thinking, there must be something else out there that I can try. I refused to …
Lemon juice for kidney stones: Does it work?
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CEO, president, and founder of the Clinician Burnout Foundation Jodie Green and physician advocate and physical therapist Kim Downey discuss their article “Why wellness programs fail health care.” Jodie and Kim explain …
Tangible support saves health care workers from systemic collapse [PODCAST]
My partner broke her femur in a Zumba class just before Christmas 2025 and had successful surgery. Following successful surgery, physicians prescribed Lovenox (an anticoagulant) and Plavix (an antiplatelet drug), the standard regimen for preventing or treating venous thromboembolism (VTE). However, the intervention proved very risky: She lost three pints of blood into her leg and required a two-pint blood transfusion, direct complications of the Lovenox and Plavix.
Physicians adopted anticoagulants …
The anticoagulant evidence controversy: a whistleblower’s perspective
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 …
5 things health care must stop doing to improve physician well-being
For nearly half a century, tramadol has been used as a pain reliever. It is not perfect, no analgesic is, but it has helped millions upon millions of patients with chronic pain. That is why recent headlines declaring tramadol “less effective” and “more risky” caught my attention. These stories were based on a single meta-analysis, which concluded that this medication offers “limited analgesic benefits” and that its harms, …
Is tramadol really ineffective and risky?
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 …
Why patient trust in physicians is declining
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, …
Mindfulness in the journey: Finding rewards in the middle
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Orthopedic surgeon Yoshihiro Katsuura, medical student Mark Polemidiotis, and premedical student Cyrus Nasr discuss their article, “Why young people need to care about bone health now.” Yoshihiro, Mark, and Cyrus explain that …
Treating your bone density like a retirement account [PODCAST]
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Three weeks after giving birth, you are hit with a blinding headache and fading vision. The next available appointment with your doctor is two weeks away. You finally go to your doctor, and your blood pressure has already reached a dangerous level without you even realizing.
The solution is straightforward. A home blood pressure monitor costs between $69 and $169. Yet most insurers will not cover it because many states do …
Why insurance must cover home blood pressure monitors
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 …
Moral dilemmas in medicine: Why some problems have no solutions
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 …
Physician non-compete clauses: a barrier to patient access
Anesthesia and sedation in dental patients has come under scrutiny in recent years, fueled in part by high-profile tragedies, such as the deaths of six-year-old Caleb in 2015, cardiologist Dr. Henry Patel in 2020, and the five media-reported deaths in 2025. These incidents serve as a stark reminder that the current landscape of dental sedation practices is fraught with inconsistencies and a lack of oversight, which can have devastating consequences …
The risks of the single-provider dental sedation model
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 …
Restoring clinical judgment through medical education reform
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Palliative care physician and certified physician development coach Christie Mulholland discusses her article, “Reclaiming physician agency in a broken system.” She shares her personal story of leaving a prestigious academic position after …
How doctors can reclaim control in a corporate system [PODCAST]
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 …
Why I left pediatric cardiology: a story of moral injury
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