The recent inclusion of moral injury as a Z code in the DSM marks a moment for mental health. Z codes place a diagnosis in an environmental or psychosocial context. After years of advocacy from clinicians and veterans, moral injury has entered our clinical lexicon. This action validates the linkage between our embeddedness in the world and our individual struggles, from soldiers and first responders to physicians navigating a broken …
You arrive on time: 8:20 a.m. for your 8:30 appointment. You’ve done your part; you showed up early, brought your insurance card, and maybe even filled out the forms online. You expect to see your doctor at 8:30. After all, that’s what the schedule says. But the clock, like the system, runs on its own rules. At 8:35, you’re still at the front desk. They’re scanning your card, verifying your …
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Psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “The crisis in inpatient psychiatric care.” In this episode, Muhamad examines the growing dysfunction within the nation’s psychiatric hospital system, …
I used to whisper it into the dark, lying awake, watching the clock creep past 2 a.m. My body was exhausted, but my mind refused to stop sprinting, running a veritable marathon most of the night. When the sun finally pushed through the curtains, it didn’t feel like morning. It felt like failure, another day to muscle through on fumes.
Sometimes that was the hardest moment of the day. Little sleep …
Imagine having to ask your competitors for permission to open a new business: a corner café, a diagnostic clinic, or a surgical center. For decades, that was the reality in South Carolina health care. Certificate of Need (CON) laws gave entrenched hospital systems the power to contest new outpatient facilities, imaging centers, and physician-led ventures. It stifled competition, raised costs, and preserved the status quo.
That era is ending. In 2023, …
Walking out of the cath lab one night after taking care of a patient with an acute myocardial infarction, a thought crossed my mind. In cardiology, we would never deploy a new device without vetting it. Before a stent ever touches a coronary artery, it undergoes bench testing, animal trials, and human studies to prove safety and efficacy. This process typically takes years, and in some cases, decades. Data points …
In a unique episode of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, sat down with a resident, although not your typical resident! Dr. Wendell Cole, an orthopedic surgery resident at the time, is also a fellow podcaster, author, and entrepreneur. Despite being in the early stages of his medical career, Dr. Cole had already built a track record of innovation and initiative. His story …
This past August, our local hospital celebrated its 50th anniversary. The media published photos from 1975 of the ceremonial groundbreaking with hospital officials, including future Chief of Staff, Dr. David Mysko.
Dr. Mysko was the first doctor I met when I joined the staff in 1987. We played on “The Hospital Mashers,” competing with other community softball teams in a city league. As a family practitioner, he probably delivered many readers …
As a psychiatry resident, I have been closely monitoring developments in the proliferation of AI chatbots for therapy. The moment feels like the ground shifting below my feet, and I have just started my career. In my clinical practice I feel unprepared to discuss how these new technologies are impacting my patients’ lives, but from my digest of national media, I am certain that a substantial number of my patients …
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Patient advocates Alan P. Feren and Joyce Griggs discuss the article “Why agency and partnership are vital in modern health care.” In this episode, Alan and Joyce explore how collaboration, advocacy, and shared …
“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. …
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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 …
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