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 …
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 …
Anesthesia and sedation in dental patients has come under scrutiny in recent years, fueled in part by high-profile tragedies, such as the deaths of six-year-old Caleb in 2015, cardiologist Dr. Henry Patel in 2020, and the five media-reported deaths in 2025. These incidents serve as a stark reminder that the current landscape of dental sedation practices is fraught with inconsistencies and a lack of oversight, which can have devastating consequences …
A modest proposal for the reform of American medicine might begin, improbably enough, in a suburban pediatrician’s office where, last week, a physician of evident earnestness instructed my adolescent son to sleep until noon whenever possible, on the theory that tardy rising is the royal road to superior intelligence. The authority cited was a single paper (published, with all due respect, in the journal Personality and Individual Differences) bearing the …
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Palliative care physician and certified physician development coach Christie Mulholland discusses her article, “Reclaiming physician agency in a broken system.” She shares her personal story of leaving a prestigious academic position after …
I retired from my pediatric cardiology practice almost two years ago, and I keep circling back to one of the final days of my career. For a long time, I told myself I had simply burned out, worn thin by the pace and the paperwork. Only with time and reflection have I realized I didn’t step away because I was tired, I stepped away because of deep moral injury.
I remember …
It was Christmas Eve 2005, and the health plan was closing at 3 p.m. By 4 p.m., the nurses, doctors, pharmacists, and support staff who handled utilization management for HIP Health Plan were already on their way home. My usual role at the health insurance company involved creating quality profiles for physicians caring for our roughly 1 million members. But that afternoon, I was covering hospital admissions so colleagues could …
It is beyond a doubt that, in many states, including the state of Maryland in which I am licensed, tort reforms for medical malpractice occupy a good part of the legislative agenda. In Maryland, tort reforms bring:
The news headlines and the online chatter are full of chest-thumping claims from both political parties about saving democracy, scandalous finger-pointing at the other guys, battles over sound bites, and circus antics to grab the attention of the media. It is easy to get distracted by all the political drama and lose sight of important facts.
When it comes to health outcomes, the U.S. is leading the world in the amount …
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Psychiatrist Farid Sabet-Sharghi discusses his article, “The psychological trauma of polarization.” Farid explains how the human psyche is evolutionarily wired for connection, making the current climate of hostility and division deeply traumatic. …
There is a stillness in the waiting room,
not exactly silence,
but a quiet that settles over chairs,
minds diverted elsewhere.
Here, women sit in chairs
with their thoughts
floating in opposing directions,
pretending to read magazines,
while their minds
wander hallways
they would rather not travel.
My name is called softly,
and my heart skips a beat,
the time has come.
I follow the routine,
changing from street clothes
into bare arms and a borrowed gown
that never seems to fit properly.
I take a deep breath,
trying …
With an overwhelming role of automation in modern health care industry, the concept of medical ethics seems to be fading away in the waves of murky economic profiting from value-based bundles meant for pure revenue generation. The commercialized approach towards practice of medicine requires readdressing the core ethical framework which lies at the hearth of patient-doctor relationship. Being innate and inextricable part of clinical medicine, ethical responsibility is meant for …
With the onset of fall and winter season, my clinic in the Bronx braces for a flood of worried parents. A toddler coming in with itchy, watery eyes and a runny nose becomes a far too common sight. Parents share of their battles against poorly ventilated apartments, mould and cockroach infestations, housing insecurities; adding to this, the threat of RSV, flu, and COVID-19 exposures in day care and school causes …
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Interventional physiatrist Francisco M. Torres discusses his article, “A doctor’s own prostate cancer recovery.” He shares his vulnerable story of undergoing a robot-assisted radical prostatectomy and the unexpected shame and “erosion of …
Laura, my department chair, is relentless in her enthusiasm for ambient AI systems in clinical care. Daily emails, weekly reminders, and even personal demonstrations; she’s convinced this is the future of medicine. Watching her, I can’t help but feel both admiration and unease. Her excitement is genuine, but I wonder if we’re rushing toward something we don’t fully understand.
And in many ways, she’s right. There’s a quiet joy in having …
I used to think the hardest part of building better health care was securing funding.
Then I watched the same cycle repeat itself: A promising pilot launches, early outcomes are celebrated, a report is written, and when the funding period ends, the program quietly disappears. The idea did not fail. It simply could not survive.
Nothing was wrong with the clinicians involved.
Nothing was wrong with the intention.
What was missing was a system.
Health …
Walk into a convenience store. You will see sleek bottles, gummies, shots, and powders in bright wrappers. Companies market them as calm, focus, energy, sleep, pain relief. People treat them like upgraded vitamins. They swipe a card and head home. Nobody runs a checklist on dose, interactions, tolerance, withdrawal, or contamination.
This culture runs on a simple story. Natural means safe and plant means gentle. Legal means regulated while a label …
Medicine teaches us to recognize disease, to listen for the subtle signs of pathology, to read lab values and imaging scans as if they are languages unto themselves. Yet what many of us were never taught is how to interpret the quiet, internal signals of our own humanity. We can identify cardiac murmurs with precision, but we often miss the whispers of our own exhaustion.
As physicians, we spend years mastering …
This is a work of fiction.
I directed Mrs. Powell to sit and make herself comfortable. She lowered herself into the chair at the round table in the lobby of my office slowly, her frail, 90-year-old frame eventually settling into it.
“How’s your health, Mrs. Powell?” I asked. This is how I approached most conversations in which a client asked if they could meet suddenly. Usually, it meant they had gotten some …
“The meds made me do it” has become a familiar refrain whenever psychiatric treatment intersects with tragedy. It is a phrase heavy with implication, suggesting loss of control, a sense of medical betrayal, and a system that failed at its most basic task: keeping people safe. When cases like the Nick Reiner tragedy enter the public consciousness, that phrase resurfaces almost reflexively, offering a deceptively simple explanation for something incredibly …
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