A clinician’s guide to embryo grading in IVF

Conditions
December 31, 2025

In the fast-paced world of reproductive endocrinology and infertility (REI), even seasoned clinicians from other specialties can find themselves lost in the weeds of embryo reports. While most of us recall the basics of mitosis and meiosis from medical school, the clinical nuances of embryo morphology and grading are often not taught until fellowship.

Understanding these metrics is essential for informed decision-making. Whether you are an OB/GYN managing patient expectations or …

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Why women’s symptoms are dismissed in medicine

Conditions
December 31, 2025

I walked out of my physician’s office steady and clear in my decision to transfer my care. I didn’t accuse her of anything. I didn’t raise my voice. I simply informed her that I would be transitioning to another clinician within the same concierge program.

She immediately assumed I was leaving for financial reasons and suggested physicians to see outside the system. When I clarified that her administrator had already approved …

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Sjogren’s, fibromyalgia, and the weight of invisible illness

Physician
December 31, 2025

Some illnesses do not storm the body to the brink of death. They don’t show up in emergency rooms or leave dramatic scans behind. Yet they quietly hollow a life from the inside, stealing ease, stealing spontaneity, turning ordinary days into endurance tests. Autoimmune disease and chronic pain often live in that space: not terminal, but relentless; not fatal, yet capable of dimming the world so deeply that survival becomes …

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When racism findings challenge institutional narratives

Physician
December 31, 2025

In the annals of social science, few imperatives are more solemnly intoned than the necessity of measuring racism with the cold precision that only quantification can provide. Only when bias is reduced to p-values and effect sizes may one confidently proclaim, “Behold, the incontrovertible evidence of racism,” secure in the knowledge that no reasonable interlocutor can wriggle free on the strength of anecdote or wounded sentiment. Yet such measurements, to …

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Early detection fails when screening guidelines ignore young women [PODCAST]

Podcast
December 30, 2025
YouTube video

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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 …

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Student loan cuts for health professionals

Policy
December 30, 2025

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 …

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GLP-1 psychological side effects: a psychiatrist’s view

Conditions
December 30, 2025

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 …

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Why lab monkey escapes demand transparency

Policy
December 30, 2025

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 …

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Emotional awareness and expression therapy explained

Conditions
December 30, 2025

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 …

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Tangible support saves health care workers from systemic collapse [PODCAST]

Podcast
December 29, 2025
YouTube video

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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 …

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The anticoagulant evidence controversy: a whistleblower’s perspective

Meds
December 29, 2025

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 …

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5 things health care must stop doing to improve physician well-being

Physician
December 29, 2025

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 …

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Is tramadol really ineffective and risky?

Meds
December 29, 2025

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, …

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Why patient trust in physicians is declining

Physician
December 29, 2025

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 …

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Mindfulness in the journey: Finding rewards in the middle

Physician
December 29, 2025

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, …

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Treating your bone density like a retirement account [PODCAST]

Podcast
December 28, 2025
YouTube video

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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 …

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Why insurance must cover home blood pressure monitors

Conditions
December 28, 2025

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 …

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Moral dilemmas in medicine: Why some problems have no solutions

Physician
December 28, 2025

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 …

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Physician non-compete clauses: a barrier to patient access

Physician
December 28, 2025

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 …

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