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Internal medicine physician Shiv K. Goel discusses his article “Claude for Healthcare vs. administrative burden: a physician’s review.” Shiv contrasts the two hours he spent fighting a prior authorization with the promise …
AI could end the administrative nightmare for doctors [PODCAST]
Most people expect a heart attack to announce itself with unmistakable force, crushing pain, shortness of breath, a dramatic collapse. Mine arrived quietly, unnoticed, and remained hidden for years. What I discovered in 2026 forced me to revisit events from 2018 and 2019 and confront how easily critical medical information can slip through the cracks when communication fails.
A routine appointment reveals a hidden past
On Jan. 8, 2026, during a routine …
Silent heart attack symptoms: my missed diagnosis story
I cannot claim to have been the one who nurtured our garden. That credit belongs to my wife. She is the one who waters the plants faithfully and notices when something needs care. I am more often the admirer, the one who pauses to appreciate a flower that seems almost too beautiful to belong in an ordinary backyard.
Among the plants that brought me the greatest joy was a passion vine. …
The passion vine: a lesson on restraint in medicine and life
Predicting shifts in the health care environment has always been difficult, but this year, the pace of change, driven by regulatory complexity, mounting financial pressures, and artificial intelligence (AI), makes long-term forecasts increasingly uncertain. Each year, TDC Group has predicted emerging health care trends over the next decade, focusing on the challenges, risks, and opportunities that shape the industry. …
The future of U.S. medicine: 10 health care trends in 2026
I read with interest HHS’s request for public input on how regulation, reimbursement, and research and development can accelerate the adoption of artificial intelligence in clinical care. As someone who began his career as a software engineer, then became a practicing physician, and later founded a clinical AI company, I welcome this moment. It is overdue, and it is also fragile.
The promise of efficiency over autonomous medicine
AI’s greatest opportunity …
Artificial intelligence in clinical care: Shaping the HHS policy landscape
The way hospitals traditionally staff is burning out nurses and killing patients.
A single call-in or unanticipated census spike creates heavier patient loads for front-line nurses. Research published in the Journal of the American Medical Association found that surgical patients have a 31 percent increased likelihood of death within 30 days in hospitals with 8:1 nurse-to-patient ratios, compared to those with the optimal 4:1 ratio.
Further, when nurses were asked why …
Predictive staffing in health care: Solving the nurse burnout crisis
An excerpt from Narrative Medicine in the Age of Uncertainty: When Systems Strain and Stories Steady.
When a nonprofit hospital system posts a $201 million operating loss, lays off roughly 650 workers, and then buys naming rights to an NFL practice facility, it does not just create bad optics. It teaches a lesson.
Not to the marketing department. To the workforce.
In Philadelphia, Jefferson Health reported a $201 million …
Why your nonprofit hospital system is spending millions on marketing
Every reproductive endocrinologist knows that ovulation is triggered by estradiol. In our textbooks, the sequence is clear: Estradiol rises, triggers an LH surge, and ovulation follows, culminating in the formation of a corpus luteum, which produces progesterone to support implantation and pregnancy. It is straightforward and reassuringly precise, and it forms the backbone of our clinical practice.
Yet, from the very beginning of training, we are instructed to use artificial ovulation …
The Dozortsev-Diamond paradigm: Is progesterone the true ovulation trigger?
In 2025, the health care industry faced a crisis that has quietly reshaped how providers think about care: administrative workforce shortages. Clinics struggled to fill roles like medical billers, schedulers, and revenue cycle specialists, with vacancies lasting over 30 days in many cases.
The impact was tangible:
The real differentiator for high-performing practices was a surprisingly human …
Administrative workforce stability: the new clinical metric for 2026
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Professor of clinical psychiatry Michael F. Myers discusses his book Physicians With Lived Experience: How Their Stories Offer Clinical Guidance and the article “Breaking the silence: mental health and racism in medical …
Physician vulnerability and authenticity: How shared stories heal [PODCAST]
In Northern California and beyond, health care systems are rapidly integrating artificial intelligence (AI) and digital tools to transform how pain is recognized, measured, and managed. From algorithm-guided assessments to wearable sensors and predictive analytics, these tools promise to augment clinical decision-making and improve patient outcomes. Yet significant controversies remain, including concerns over algorithmic accuracy, bias, data privacy, and the extent to which technology should complement or potentially displace human …
AI in pain assessment: Balancing innovation with patient safety
This article is sponsored by InCrowd.
Health care professionals are constantly navigating changes in policy, clinical evidence and practice expectations all while delivering patient care. Over the past several months, InCrowd has been asking health care professionals across the United States to share their perspectives on three major developments: changes to nursing degree classifications, a state-level bill in Massachusetts that …
It is very cold in Islamabad. These days, I feel overwhelmed by joblessness, the constant lack of money, an upcoming medical exam, and the slow progress I am making in life. Apart from studying for my upcoming medical exam, the most consistent part of my routine has become counting money. I check all my bank accounts, calculate every remaining rupee, and make small, anxious plans about how I will manage …
Winter in Islamabad: Finding hope in the daily struggle
Physicians are renowned for their dedication to helping others. The problem is that their dedication has become synonymous with self-sacrifice and working for free.
Giving away time, energy, and expertise is simply “what good doctors are supposed to do.”
We work through lunch. We attend meetings during lunch. We respond to patient messages on our days off. We prepare lectures and teach without compensation. Leaders hold space for complaints and conflict and …
The hidden cost of uncompensated work on physician burnout
When I experienced burnout as a young primary care physician, I thought it was my fault. Actually, I didn’t know it was burnout; I had never heard the word. But I believed whatever was causing the deep exhaustion, lack of empathy, and feelings of uselessness were surely due to a flaw or weakness in me.
Eventually, I stumbled across the definition of professional burnout. I was so curious to understand what …
Physician burnout solutions: Why system change isn’t enough
For years, the conversation about board certification has centered on fairness, cost, and evidence. But there is another consequence that gets far less attention: how these systems affect the supply of practicing physicians.
America’s physician shortage isn’t theoretical anymore. It is here. Hospitals are scrambling to fill call schedules, rural communities are waiting months for specialist appointments, and medical groups are watching senior clinicians retire earlier than planned. Among the many …
How board certification fuels the physician shortage crisis
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Developmental behavioral pediatrician Roxanne Almas discusses her article “The making of a rested healer.” Roxanne shares her deeply personal journey through the “quiet unraveling” of burnout and the profound grief of losing …
Rest is a holy practice: Reclaiming the soul of medicine [PODCAST]
After working close to 20 years in this medical-surgical ICU, I thought I was an expert. Infallible. I could do it all.
I left my ICU comfort zone, my lifelong nurse friends, and ventured out. Nothing could stop me.
For a different hospital system, I became a critical care resource nurse.
This very large hospital system would dictate what unit I would go to and for how long. I truly thought I could …
Why I left the surgical-trauma ICU: a nurse’s story of burnout
America is ready for an honest conversation about health care policy before more people suffer and we go broke waiting for it to happen. Fully one-third of Americans report that in the past 12 months they have skipped or postponed getting needed health care because of the cost. Thirty percent say that they or a family member had problems paying for health care in the past year, and 41 …
American health care policy reform: Why we need a bipartisan commission
How one reframing changed the way my patients think about me, and their health.
Every day, a patient sits across from me, arms crossed, waiting for me to tell them what pill to take. Or worse, waiting for confirmation of what they already believe: that the medical system has nothing real to offer, their doctor is just a middleman for pharma companies or an insurance shill, and that the answer to …
Rebuilding patient trust through the evolutionary mismatch framework
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