We often hear the phrase “practice what you preach.” As both a physician and a patient, I’ve learned that nowhere is this more important than in how we navigate health care.
Over the years, I’ve written about the importance of collaboration between physicians and patients. But as I’ve grown older and more frequently interact with the health care system, I’ve come to believe that good care rests on four essential elements:
“It’s not just in your head.” For people living with complex PTSD (CPTSD), these words offer more than comfort—they offer scientific truth. Trauma doesn’t just scar the mind; it reshapes the brain. But so does healing.
The hidden epidemic of CPTSD
Unlike its better-known cousin PTSD, complex PTSD often emerges from prolonged, repeated trauma—domestic abuse, childhood neglect, trafficking, emotional captivity. And while DSM-5 only nods to it, millions silently live with its …
WeightWatchers (WW) recently completed a broader financial reorganization, realigning leadership with a sharper focus on clinical innovation and women’s health, including menopause support. The reorganization includes appointing a chief medical officer to lead a more integrated, medically informed approach.
WW’s reorganization bankruptcy was driven by mounting debt and pressure from newer weight-loss therapy products, namely GLP-1 drugs like Ozempic and Wegovy. It was also impacted by a shifting landscape where traditional …
Rising costs are dominating kitchen table conversations across the country, and health care is no exception. In response, federal and state regulators have introduced a range of proposals to curb spending and improve efficiencies—some thoughtful, others deeply flawed. As a former emergency medicine physician and now a health care executive with over three decades of experience, I’ve seen what works and what doesn’t. If we’re serious about cost control, we …
Benign prostatic hyperplasia (BPH), commonly referred to as an enlarged prostate, is a highly prevalent condition affecting millions of men as they age. While it is not cancerous, its impact on daily life can be significant, causing lower urinary tract symptoms (LUTS) such as frequent urination, weak stream, urgency, or nocturia.
Over the past decade, treatment options for BPH have expanded considerably. In addition to medications and conventional surgery, there are …
An excerpt from Pandemics, Poverty, and Politics: Decoding the Social and Political Drivers of Pandemics from Plague to COVID-19.
Many transgender (TG) people live with the constant threat of violence. International research documented a total of over 2,000 murders of TG humans between January 2008 and April 2016.43 (These findings are likely greatly underreported.) Even more widespread is nonlethal violence against TG communities. A national U.S. study indicated that 35 …
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Pediatrician and certified coach Jessie Mahoney discusses her article, “Why judgment is hurting doctors—and how mindfulness can heal.” She argues that the culture of medicine is steeped in judgment—from the language of …
Chronic kidney disease (CKD) affects more than 1 in 7 U.S. adults, while approximately 2 in 1,000 are living with end-stage kidney disease (ESKD)—kidney failure that is treated either with a kidney transplant or through dialysis. Today, however, there is much that can be done to prevent kidney failure if CKD is diagnosed early and comorbid conditions are well managed. Patients with CKD and ESKD have multiple complex chronic …
Are you serious? It’s 2 a.m., and you take a patient to the OR for what you believe is a bowel obstruction or appendicitis — only to find metastatic cancer, necrotic bowel, or something equally catastrophic. The patient is unstable, anesthesia is struggling to maintain blood pressure, and you can’t simply apply a wound vac and leave the patient in the ICU. This is when your training must take over.
Since …
I sat in my pink childhood bed, my name still written in cursive above it from when I redesigned the room at seven years old, staring at the letter that shattered my dream. I had been dismissed from medical school for “professionalism” concerns. I didn’t know what came next. No roadmap. No support. Just the crushing reality that everything I had worked for was suddenly gone.
Medical education demands resilience and …
A faculty-wide email recently announced that shadowing in our emergency department would no longer be recognized as a valid educational activity. I wrote back asking why. The reply was brief, dismissive, and telling:
“It doesn’t pay the rent.”
That line has stuck with me—not just because it was flippant, but because it revealed something deeper about how we now view education.
Shadowing has long served as the first bridge between curiosity and calling …
Hospital employment was once billed as the solution to the headaches of private practice — a way to gain stability, reduce administrative burden, and focus on patient care. But for many physicians, that promise has come undone.
According to the Physicians Foundation’s 2024 report, 60 percent of physicians report frequent feelings of burnout — the highest level on record. Instead of feeling supported, many employed physicians feel …
One of the most important—and least discussed—truths in medicine is this:
Feeling inadequate in medicine isn’t rare. It’s everywhere—quiet, lingering, relentless.
I remember starting my outpatient practice right out of residency. I had joined a large multispecialty group filled with physicians trained at top-tier institutions. Many had been practicing for decades. They were confident. Efficient. Experienced. I was still waiting on my board scores—unsure if I was even certified yet. And yet—there …
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Despite decades of public health messaging urging children to “eat less and move more,” rates of pediatric obesity continue to rise globally. In the U.S. alone, nearly 1 in 5 children and adolescents aged 2–19 years have obesity, with higher rates among those from low-income or minority backgrounds. While caloric balance is a basic principle of weight regulation, the oversimplification of obesity into a matter of willpower neglects the …
The evolving contemporary era of value-based health care (VBHC) demands new risk leadership. VBHC emphasizes quality, outcomes, safety, equity, and stakeholder satisfaction. With these goals come complex, cross-cutting risks, including workforce shortages, clinical complications, health care staff safety, cyberattacks, and supply chain disruptions. To address the modern risk situation, health care systems must allocate resources to resilient, enterprise-wide risk governance and innovations.
The enterprise risk management (ERM) framework is the centerpiece …
Personal resilience is one of the three core components of the Stanford model of physician professional fulfillment, used across institutions to inform provider well-being strategy. Yet, limited data suggest only a minority of physicians view personal resilience initiatives as beneficial to their well-being, and physicians have expressed resistance and frustration toward organization-based individual resilience promotion.
I have led and participated in workplace meditation courses, stress management talks, …
I was midway through a busy afternoon clinic when my pager erupted—an inpatient consult request. The case sounded messy: Chronic pancreatitis that had suddenly spiraled downward. A fresh, sizable mass sat in the pancreatic head; tumor markers were positive. Two endoscopic biopsies had failed, and surgery felt too risky for this frail patient. Cancer seemed the only plausible answer.
Rheumatology—my service—was called in because her ANA was weakly positive (1:40). In …
The threats we face throughout our medical practice years are rarely published in the world medical practice literature for a good reason. The medical practice system has so many disruptive, threatening, and hidden educational factors to confess to that it is a miracle we have any American physicians still practicing today. That needs to be changed.
Most physicians in private medical practice, who suffer the most economically, are now reaching their …
As a quadruple board-certified physician and a patient with a complex autoimmune disease, I live on both sides of the examination table. My professional life is about finding answers; my personal life has been about the agony of waiting for them.
This dual perspective makes it impossible to ignore a systemic problem in modern medicine: A class of diagnoses that live in the shadows. Seronegative Sjögren’s, mast cell activation syndrome (MCAS), …
Most people think of high blood pressure as a silent threat to the heart. But it’s time we start talking about another organ it quietly destroys: the kidneys.
As a public health researcher and clinician, I have seen how chronic kidney disease (CKD) creeps in unnoticed—especially among older adults—and how hypertension is often the unspoken culprit. Despite being preventable and treatable in its early stages, CKD remains a major cause of …
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