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Patient advocate Eric Goldfarb discusses the article “How a pregnancy test on a male patient revealed health care flaws.” Eric shares the absurd and heartbreaking story of finding a pregnancy test charge …
Why hospital systems fail to notice the human behind the bill [PODCAST]
You tell me it is all in my head.
As though my head were a small room where false alarms
ring for sport,
like I have no better way to spend my time and life.
You hold films up to the light,
of bones and blood,
nothing cracked or out of place,
or a catastrophe waiting in the wings
that has earned a name in your stack of books.
My blood you have drawn
has traveled through your machines
and has …
A patient’s poem on invisible illness and trauma-informed care
A dry cough can be one of the most misleading symptoms in medicine. At home, it can dominate the emotional climate of an entire household. It interrupts sleep, breaks conversations, unsettles meals, and keeps caregivers in a state of low-grade vigilance. It appears in cold air, at the beginning of a speech, during the first few sentences of a phone call, or in the quiet moment when everyone is finally …
How a minor dry cough amplifies caregiver burden in home health care
If you have nagging pain deep in your lower back or one buttock that never seems to settle, you are not alone. Many people chase answers through discs, nerves, or muscles, yet the real source turns out to be the sacroiliac (SI) joint. This connection between the base of your spine and your pelvis is built for stability with just a hint of motion. When it becomes irritated or unstable, …
How to treat sacroiliac joint pain effectively today
I want to tell you something attorneys already know but will never say to your face. When your expert report lands in their inbox and they read it, I mean really read it, they know within the first two paragraphs whether they are calling you again. Not after the case. Right then. And if the answer is no, they do not tell you. They do not give feedback. They do …
Why clinicians fail at writing expert reports
In September 2025, The Atlantic reported on a frenzy surrounding leucovorin, a folate derivative long used in oncology and rheumatology. Families desperate for answers were suddenly told it might be a miracle therapy for autism. Waitlists stretched years, clinics were overwhelmed, and hope surged. The problem was not just scientific, it was political. When President Trump and HHS Secretary Robert F. Kennedy Jr. endorsed leucovorin, they amplified demand …
Leucovorin for autism: Why physicians must protect hope from hype
We are nearing the end of the academic year, and I recently found myself standing in front of a room of first-year medical students offering what I called “observations.” Not punishments. Not a lecture. Observations. And an invitation. Because what I had been seeing was concerning: academic dishonesty, inappropriate use of artificial intelligence (AI), emotional volatility, and a level of disengagement that felt at odds with a curriculum intentionally designed …
Driving medical education reform through intellectual honesty
The internet has made patients more informed. It has also made some patients more misled. A small but growing body of medical commentary has used the provocative label “internet-derived information obstruction treatment (IDIOT)” syndrome to describe what happens when people trust online medical content so blindly that they delay care, stop treatment, self-medicate, or resist sound clinical judgment. The term appears in published reviews and commentaries, but it is not …
How IDIOT syndrome threatens value-based health care
Artificial intelligence is rapidly acquiring a reputation as an unreliable, even dangerous, force in medicine and drug development. Hallucinations, opaque decision-making, and high-profile failures have fueled resistance to its adoption across health care systems. But this backlash reflects not an inherent flaw in AI itself, it reflects how we are choosing to use it.
The dominant mistake is conceptual. We are treating AI as a replacement for human reasoning rather than …
The real problem with AI in medicine and drug development
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Internal medicine and functional medicine physician Shiv K. Goel discusses the article “Why lifestyle matters more than BPC-157 and semaglutide.” Shiv explains how the modern longevity boom has trained patients to seek …
True metabolic healing requires more than just prescribing expensive peptides [PODCAST]
The day I handed in my credentials as medical director, I sat in my car in the parking lot for a long time. I had held that role at Methodist Specialty and Transplant Hospital in San Antonio for years. I had built protocols, chaired committees, mentored residents, and managed crises at hours when the rest of the city slept. I was, by every conventional metric, succeeding. And yet there was …
Why leaving hospital medicine for private practice was worth the risk
These moments of hesitation keep happening to me. I recognize the harm. I can name it clearly. I have seen its effects over and over again with my patients. And yet, when the conversation turns to its cause, I hesitate. Not because I do not understand. Because I am supposed to stay neutral. Medicine has long held neutrality as a professional virtue. We are taught to rise above politics, to …
Why physician neutrality in the face of harm is a choice
In health care, we are trained to measure what we can quantify. We check blood pressure, glucose, cholesterol, and weight. We monitor lab trends and adjust medications. We look for numbers that confirm risk. What we do not routinely measure is whether a patient is living in a constant state of stress, even though the signs are often right in front of us.
In dentistry, those signs are hard to miss.
Over …
The hidden link between chronic stress and oral health
At 2 a.m., the hospital is quieter but the stakes are not. A single page can alter the trajectory of a patient’s life. A subtle clinical shift can mark the difference between stability and decline. At night, there is less margin for error, fewer immediate resources, and no room for hesitation. Not long ago, I was called to evaluate a patient who “just did not look right.” The vital signs …
How night shift medicine exposes the reality of physician stress
Modern medicine loves numbers. LDL. A1c. BMI. Tumor diameter. Pounds lost. They are easy to measure, easy to track, and easy to celebrate. But none of them are the disease itself.
As GLP-1 prescribing accelerates and insurers increasingly define success by weight reduction, we are repeating a familiar mistake: Elevating a surrogate marker to the status of a biological endpoint.
BMI was never designed to diagnose disease in individuals. Adolphe Quetelet created …
GLP-1 agonists and weight loss: Treating the disease, not the number
In clinical practice, reassurance is both necessary and responsible. When a clinician says “nothing concerning,” it is rarely casual. It reflects a judgment: no immediate danger, no clear evidence of serious disease, no indication for urgent intervention. It is often the appropriate conclusion at that moment in time. But what happens to that statement after the visit ends is less often considered. Because outside the clinical context in which it …
How clinical reassurance impacts patient communication
An excerpt from The Leadership Prescription: How High-Performing Clinicians Become Visionary Leaders.
There I was in my habitual rhythm, seeing patients back-to-back and enjoying it. After all, seeing the patients was the fun part; the administrative burden that accompanied it was nauseating and heralded the real risk of burnout. The administrators regarded me as someone who could easily create rapport with the patients. I was the kind of physician who …
The physician leadership transition: Moving beyond the exam room
In the wake of the October 2023 Hamas attacks on Israel, allegations of antisemitism surged on American campuses, including at the University of Pennsylvania. In response, the Equal Employment Opportunity Commission (EEOC) launched a Title VII investigation and subpoenaed Penn for the names and contact information of faculty and staff affiliated with Jewish organizations and Jewish Studies programs. Penn resisted. Faculty groups intervened. The phrase that reverberated through court filings …
Balancing civil rights and trauma in an antisemitism investigation
As physicians, we rarely disagree about first principles. Nutrition, physical activity, sleep, stress, and behavioral patterns sit at the foundation of nearly every chronic disease conversation. We counsel patients on these topics every day, sometimes passionately, sometimes hurriedly, often within the narrow time constraints of a packed clinic schedule.
Yet an uncomfortable gap persists between what we know drives long-term outcomes and what we are realistically able to deliver in routine …
Lifestyle medicine support: Bridging the gap in patient care
An excerpt from The Temple Road: A Doctor’s Journey by permission of Texas Tech University Press. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Throughout my years in medical training, I had heard the maxim, “Medicine is an art.” And yet this notion seemed abstract to me; after all, I had been steeped in science.
Then I came under the …
The art of medicine and clinical reasoning: a lesson at the bedside
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