“Why don’t they see?” “Why can’t they understand?” “Why are they doing this to us?”
These questions echo in exam rooms, in meetings, in the hallways of hospitals and clinics across the country. They are often sparked by policy changes, institutional decisions, or administrative mandates that feel disconnected from the physicians providing the care. Underneath the questions is the hope that the reality in front of us isn’t actually true. That …
For decades, cholesterol (LDL, HDL, triglycerides) has been the central focus of cardiovascular prevention. But in recent years, another player has emerged: lipoprotein(a), or Lp(a).
Many patients have never heard of it, yet research shows it may be one of the most important genetic risk factors for heart disease.
What is lipoprotein(a)?
Lipoprotein(a) is a particle in the blood similar to LDL cholesterol, but with an added protein called apolipoprotein(a). This structure makes …
America’s mental health system is failing its seniors, caught in a perfect storm of: a rapidly growing population, a severe shortage of geriatric psychiatrists, and a Medicare model buckling under the weight of chronic, costly conditions. For millions of older adults living with anxiety, depression, or isolation, the system offers little or no treatment; often, the nearest provider is hours away, and waitlists stretch for months. …
As a physician with decades of experience, I have watched health care in this country change from a patient-centered calling into a profit-driven corporate enterprise. Much of the current political rhetoric surrounding the Affordable Care Act (ACA) conveniently ignores the real structural issues that drive up premiums and reduce access for ordinary Americans.
The recent claim that, if Republicans “get their way” and ACA tax credits expire, insurance costs will skyrocket …
For the longest time, I believed that if I gave myself fully, 24/7, to work, to my son, to my marriage, to my friends, then eventually, everything would fall into place. That maybe, just maybe, I would finally be able to answer every message, refill every prescription, kiss every scraped knee, and fix all the things.
But what I’ve come to understand is that we, especially women, though not exclusively, often …
As a physician, I know all too well what clinicians in the U.S. today are up against. We’re being asked to do a lot more with a lot less. We’re tasked with producing more complete and accurate clinical documentation, reviewing endless notes, coding our own charts, and improving patient flow, all while providing the best patient experience and ensuring quality scores are optimal. All in a day’s work, right?
Our hippocratic …
They tell me the physician’s art lies in the stitching of skin,
the analysis of shadows on X-rays,
and interpreting numbers in a medical chart.
Yes, there is skill involved.
a steady hand, a quick eye,
and a good memory for pathways and procedures.
But I wonder.
where, in the span of 20-25 minutes,
is the art that cannot be quantified
or coded?
It’s found in the stillness of listening,
in the weight of one person’s story
resting in another’s hands.
A doctor …
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Family physician Grace Yu discusses her article “The backbone of health care is breaking.” In this episode, Grace reflects on the urgent decline of the primary care workforce and the growing crisis …
This past summer, I was diagnosed with prostate cancer. For more than three decades, I have taught, examined, and guided patients through various types of illnesses. However, nothing prepared me for the disorienting effect of becoming a patient myself. The diagnosis itself (a less aggressive prostate cancer amenable to robot-assisted radical prostatectomy) felt, at first, like a technical problem with a straightforward surgical solution. But what I did not fully …
It’s no secret, is it? Health care organizations and institutions are struggling, some more than others. However, all are faced with seemingly insurmountable challenges. Demand outstripping resources, failing cultures and disengaged staff, and everywhere blockages and lack of flow are but a few of the common themes.
Big money, large initiatives, and great minds have all been thrown at the problem. The result? Well, if there was an answer we would …
Peace in the Middle East was once considered impossible until someone had the courage to take a stand and chart a new course. Mr. President, we need that same clarity and boldness now in health care.
The government shutdown over health care isn’t about medicine, it’s about money. Costs have exploded while premiums skyrocket. Paradoxically, doctors earn less, hospitals consolidate, and patients wait longer. The focus has shifted from healing to …
The Trump administration recently released a long-promised report decrying the sorry state of the health of American children and saying how it planned to change this.
They correctly begin by noting that “Despite outspending peer nations by more than double per capita on health care, the United States ranks last in life expectancy among high-income countries and suffers higher rates of obesity, heart disease, and diabetes.” Unfortunately, they then largely focus …
I spent 11 years becoming a family physician.
Four years in undergrad, four in medical school, three more in residency.
That’s a decade of delayed income and about $300,000 in debt, all for the privilege of practicing in one of the most critical, underappreciated corners of medicine: primary care.
I came out idealistic. I wanted to build relationships, prevent disease, and guide people through the chaos of a broken system. But I quickly …
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Introduction: a crisis of pain
The opioid crisis is one of the most significant public health emergencies of our time, defined by staggering rates of addiction and overdose. Yet, behind the headlines is a story of profound and often overlooked human suffering. In an effort to save lives, public health policies were enacted to aggressively reduce opioid prescriptions. While well-intentioned, these policies have inadvertently precipitated a parallel crisis of iatrogenic harm, …
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Psychiatrist Yekaterina Angelova discusses her article “Are you addicted to false urgency?” In this episode, Yekaterina explores how modern professionals, including physicians, get caught in a cycle of constant busyness and fabricated …
The unpaid backbone of a billion-dollar scientific publishing industry
Not long ago, I received yet another “urgent” peer review request from a major medical journal. The email hit all the familiar notes: “We value your expertise. Your contribution is essential to scholarly excellence. Please respond within 72 hours.”
I glanced at the journal’s website. Their open-access fee? $3,800. Reviewer compensation? Zero.
This is the quiet hypocrisy we’ve all come to accept: Journals charge …
AI is rolling out in medicine faster than most of us can process. Ambient scribes documenting visits. Clinical decision support algorithms. Automated prior authorizations. The promises are compelling: reduced clerical burden, more face-time with patients, less burnout.
I wanted this. As a palliative care doctor and director of physician well-being at my institution, I’ve spent years watching colleagues drown in documentation and burn out from relentless task loads. When AI tools …
My son Gideon is almost 12 years old. He is funny in that sharp, unexpected way that catches you off-guard. He is deeply expressive and full of life. He gives love and joy more freely than most kids his age. He is curious and social. He is healthy, and I am grateful for it. We are endlessly proud of who he is.
And, our family constantly walks the edge of breaking …
When parents bring their children to the clinic, they often expect quick advice: “Eat healthy. Exercise more.” But after years in practice, I’ve learned those generic prescriptions rarely work. Families leave feeling uncertain, children feel pressured, and real changes at home are hard to sustain.
That’s why I focus on a family-centered, personalized approach. Nutrition is not just about a child; it’s about routines, traditions, and stresses that affect the whole …
When most people think of seizures, they picture someone falling to the ground with violent shaking, the dramatic scenes we’ve seen in movies and television. While these tonic-clonic seizures (previously known as grand mal seizures) do occur, the reality is that many seizures look nothing like what Hollywood portrays. They are often subtle, easily missed, and can be mistaken for daydreaming or unusual behavior.
More than 3 million Americans have active …
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