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Family physician Travis Walker discusses his article “A physician father on the Dobbs decision and reproductive rights.” Travis reflects on the glaring double standard facing his daughter compared to his sons in …
Physician father wrestles with daughter’s post-Dobbs future [PODCAST]
If you are frustrated by your high tax bill, you are not alone. I have spoken with many doctors who experience sticker shock when they see their total annual tax liability after completing residency. Stories in the media, such as The Atlantic’s recent study on billionaire taxes, about how rich people avoid taxes only fan the flames. It is no surprise, then, that one of the most common financial …
Physician tax strategies: Why your tax bill is so high and how to fix it
The attending scrolls through the chart before morning rounds. The progress note is polished. The assessment is structured. The differential is surprisingly thorough. A predictive model flags the patient as high risk for deterioration within 24 hours. He did not write most of it.
An AI assistant drafted the note. A risk algorithm generated the alert. A decision-support tool suggested broadening the workup. He reviewed it. He agreed with most of …
AI in clinical documentation: Who is liable for medical errors?
“The problem is not that physicians play games. The problem is that we are embarrassed to admit we need ways to feel alive again.”
At 3:17 a.m., we called the code. Thirty minutes of compressions. Three rounds of epinephrine. A room filled with controlled urgency. When it ended, the monitors fell silent before the hallway did. I finished my documentation. I washed my hands. I walked to my car. And I …
Physician burnout and gaming: Why doctors turn to video games
After more than 25 years in oncology rehabilitation, clinical education, and survivorship care, I’ve learned to be cautious about “good” numbers from common tools like BMI and bathroom scales that don’t match what is actually happening in the body. A recent study confirms it: When used alone, BMI has been found to misclassify up to 34 percent of the general population as obese.
This year, it became more personal when …
Beyond BMI: Why weight management must look inside the body
Treatment of people who use tobacco is different. Most treatments given to patients are reasonably successful, but cigarette smokers who are trying to quit will make multiple attempts before they remain abstinent, sometimes as many as twenty. Within hours of stopping, nicotine users can begin to experience withdrawal symptoms which include craving, anxiety, irritability, and restlessness that continue to increase and can rapidly be relieved by another cigarette.
Some people trying …
Learned helplessness and self-efficacy in tobacco treatment
Unfortunately, we’re all too familiar with the tragic headlines:
We can easily conclude from these stories that ketamine, propofol, and fentanyl are inherently dangerous substances. When used irresponsibly or in the wrong hands, they are dangerous. But as an anesthesiologist, I, and many other medical professionals, use these …
The truth about ketamine: an anesthesiologist explains drug safety
As a pain physician, I spend my career advocating for patients who struggle to access appropriate pain management. I write often on hurdles like restrictive opioid policy, excessive regulatory scrutiny, prior authorization, and administrative burdens that detract from patient care. Yet nothing prepared me for the visceral reality of being the patient on the other side of the system.
From physician advocate to patient in the system
My recent experience, unrelated to …
Why doctors struggle with health care system delays
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Internal medicine physician Sally Daganzo discusses her article “The hidden epidemic of orthorexia nervosa.” Sally explains how the pursuit of a perfect diet can spiral into a debilitating obsession where food rules …
Orthorexia nervosa turns healthy habits into a harmful obsession [PODCAST]
The fissuring of health care, along the lines of “The Fissured Workplace: Why Work Became So Bad for So Many and What Can Be Done to Improve It” by David Weil (2014), may not be entirely negative after all. Outsourcing patient contact services, perioperative or otherwise, to centralized, multilingual third-party entities with nationwide reach may be the need of the hour in an ever-evolving multilingual society seeking health care. In …
Outsourcing patient contact: a solution for multilingual health care
An excerpt from Physicians With Lived Experience: How Their Stories Offer Clinical Guidance (APA Publishing, 2025).
Foreword by Jennifer Breen Feist
Foreword by Jennifer Breen Feist, who lost her beloved sister, Dr. Lorna Breen, to suicide on April 26, 2020. After describing the initial shock and unwanted global publicity of her death, she wrote this:
As the emails, letters, and phone calls continued to pour in, my husband …
Physician mental health and suicide prevention: stories of survival
I recall the moment I fully grasped the critical importance of the physical exam and how easily it can be overlooked, often with serious consequences.
Early in my fellowship, an elderly patient was referred to our team with an apparently straightforward case of sciatica. His MRI revealed a disc herniation at L5/S1 with foraminal narrowing, prompting discussion about whether an epidural injection or surgery would be more beneficial. I was tasked …
The enduring value of the physical exam in modern medicine
Recently, Dr. Tara Kiran made headlines when her robust national OurCare survey revealed 5.9 million Canadians still lack a primary care provider, the point-of-entry health professional, like a family doctor or nurse practitioner, who provides routine care.
Those who do have a primary care provider often wait weeks for an appointment, then get rushed through in minutes. Emergency departments overflow with patients who have nowhere else to go.
The federal government …
From Singapore to Canada: a blueprint for primary care transformation
I recently went to Quest Diagnostics for a TB test and a couple of basic labs my doctor ordered. At check-in, I recalled my insurance had changed in the new year and I did not have the updated information readily available. I did not have time to reschedule nor sort it out so figured I could pay cash and reconcile it later. That seemed reasonable, if inconvenient.
When I asked what …
Health care price transparency: Why patients are bypassing insurance
A few weeks ago, I went to the DMV to renew my driver’s license. At the very end of the process, after the routine questions and fine print, a single prompt appeared with a small checkbox next to it: Do you want to register as an organ donor?
I selected “yes,” but then I paused. Not because I was conflicted, but because I realized how easily I could have done nothing. …
Opt-in vs. opt-out: How defaults shape organ donation rates
The holidays are good for the soul, but often hard on the heart. Weeks of indulgent meals, disrupted sleep, increased alcohol intake, stress, and inconsistent routines can quietly strain cardiovascular health, especially for men. As the calendar turns and routines resume, the post-holiday period presents a valuable opportunity to reset habits, reflect on seasonal excesses, and refocus on heart health before temporary behaviors become lasting risks. Understanding how seasonal habits …
Post-holiday heart health: How to reset your cardiovascular habits
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Psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “Psychedelic-assisted therapy: science, safety, and regulation.” Muhamad explores the complex landscape of psychedelic medicine, balancing the growing public interest with …
Navigating the hype and hope of psychedelic medicine [PODCAST]
I went in for a routine dental cleaning. It was never provided.
I’ve spent my career on multiple sides of health care, independent practice, hospital-owned systems, and health insurance, which has made me acutely aware of how incentives and operational norms can quietly shape care. Still, what happened during this visit surprised me.
After I was brought back to the exam room, I was told bitewing X-rays would be taken before the …
Informed refusal vs. denied care: a dental case study
Decades ago, becoming a doctor felt like the obvious choice. People asked, “Why wouldn’t you?”
Today, the question has flipped: “Why would you ever do that?”
I’m a doctor. I graduated from UCLA, and I’m now an anesthesiology resident at Mount Sinai. I also help thousands of premeds get into medical school every year. And when I see doctors leaving medicine or premeds walking away before they even apply, I don’t think …
Informed consent for premeds: Is a medical career worth it?
We are taught to watch for conflicts of interest in the form of pharmaceutical pens and consulting checks, yet we often overlook the most pervasive corruption of all: the ticking of the clock.
We traditionally describe medical conflicts of interest in corporate terms: free dinners, speaking fees, and consulting arrangements. These temptations are real, and they deserve the scrutiny and rules we apply to them. But they are external distractions. The …
The ticking clock: How time constraints in medicine hurt patient care
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