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Vascular surgeon Xzabia Caliste discusses her article, “The silent disease causing 400 amputations daily.” She shares the heartbreaking personal story of witnessing both her aunt and uncle lose their limbs to peripheral …
During one of my junior internships, I met a patient whose care challenged not so much my medical knowledge as my understanding of culture. Mr. L., a 20-year-old university student originally from China, presented to the clinic with complaints of low back pain. He firmly believed his back pain was caused by an “improper” posture. During our discussion aimed at clarifying this misconception, I encountered considerable resistance. After speaking with …
“Doctors need to develop resilience against burnout!”
After 20 years in medicine, every time I hear this, my jaw tightens, and my TMJ reminds me I have a very limited tolerance for nonsense.
Let’s call this what it is: not burnout, exploitation.
You cannot “resilience” your way out of systemic extraction. You cannot mindfulness your way out of an industry built on squeezing more and more labor out of you for less and …
U.S. health care, once a citadel of innovation and quality, has sadly devolved into a complex, frustrating, and frequently inaccessible system. It is so disorganized and inefficient it might not even meet the definition of a “system.” U.S. health care fails to address the needs and expectations of patients on many occasions and in many ways. For most of my career, I have considered U.S. health care the best in …
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Pediatric endocrinologist Shara Bialo discusses her article, “Why type 1 diabetes screening should be part of back-to-school.” She highlights that back-to-school visits are a critical window to screen for type 1 diabetes …
Across society, AI is being adopted at an staggering rate. In medicine in particular, AI is helping physicians analyze diagnostic tests, calculate disease risk, summarize patient history, and formulate treatment plans. Health care administrators are using AI to manage and optimize workflows. Insurance companies report that AI is improving consumer service, expediting claims, and detecting fraud. AI-assisted medical research is discovering new drugs to combat Parkinson’s, …
I am a pediatrician. I am a mother. And now, a grandmother. These identities don’t always move in harmony.
When I learned my twin granddaughters had been born at home, the physician in me reacted immediately. My mind began cataloging risks, reviewing worst-case scenarios, mentally scanning for everything that could have gone wrong.
The grandmother in me, however, was called to show up differently: with love, not fear. With presence, not panic. …
I grew up hearing stories about my grandfather, Dr. Luis Torres Díaz, the way some children hear stories about national heroes. In our family, he was one of them. He was not a war hero or political figure but a quiet, thoughtful, and brilliant scientist. My grandfather was a chemist, a poet, a professor, a dean, a museum founder, a man whose life seemed to stretch across disciplines with an …
I read Zoe Crawford’s thoughtful KevinMD essay on the limitations of direct primary care (DPC) with great interest. Her frustration as a medically complex patient navigating a fragmented health care system will resonate with anyone who has struggled to obtain timely imaging, referrals, or specialty care. As a clinician who has spent a career thinking and writing about how health systems fail both patients and physicians, I agree with …
Today I am a urologist, a cardiologist, a psychiatrist, a rheumatologist. But truly, I am a rural family medicine doctor in one of the most underserved counties in the country. And I am tired.
I do not pretend to have the depth of each specialist. What I have is necessity, a toolkit built on scarcity. Practicing medicine on an island, where specialists are rare, calendars are full for months, and visiting …
For years, hospitals have been urged to modernize. We are told to digitize workflows, optimize performance, and rely on dashboards and algorithms to improve efficiency. Much of this advice is reasonable. Medicine cannot function without systems.
But recently, while observing hospital transformation from within, I began to feel a familiar unease, one I had encountered before outside of medicine.
It reminded me of how digital platforms operate.
Platforms are not inherently unethical. They …
The frequency and severity of physician burnout have resulted in an epidemic that is impairing the American health care delivery system. Herbert Freudenberger coined the term burnout in 1977, referring to a syndrome characterized by emotional exhaustion, depersonalization or cynicism, and a lack of personal accomplishment. He noted that burnout reduced health care workers’ ability to provide excellent patient care and adversely affected their well-being.
Physician burnout is rampant in the …
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Double board-certified obstetrician-gynecologist and reproductive endocrinology and infertility specialist Erica Bove discusses her article, “Why do high-quality IVF embryos fail.” Erica explores the heartbreaking reality of recurrent implantation failure, challenging the assumption …
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Adapted from Searching for Normal: A New Approach to Understanding Mental Health, Distress and Neurodiversity. (Penguin Random House Canada/Signal, 2025.)
February 1992. I’m in the consulting-room side of a one-way mirror divide. Opposite us in the room are four people: thirteen-year-old Sofia, her older sister Julieta, and their mother and father. The parents speak with a strong Spanish accent. The girls’ mother has an anxious look on her face. She …
Most of us have heard the ancient Indian and Buddhist parable “the blind men and the elephant.” Regardless of source, the parable usually contains these elements:
A ruler assembles several blind men and brings an elephant before them. One feels the head and says the elephant is like a pot; another the ear and says it is like a fan; another the leg and says it is like a pillar; another …
As a medical student, I’ve seen firsthand how stress and cognitive overload can wear people down, both in patients and in myself. During one particularly difficult exam block, a friend casually mentioned L-theanine, a supplement found in green tea, that supposedly helps with focus and calm. That got me curious: Was this just hype, or is there actually something to it?
So I took a closer look at the research.
L-theanine is …
I’ve been thinking about “choice” a lot lately, not the rich, ethically grounded version we teach in medical school, rooted in autonomy, informed consent, and shared decision-making, but a thinner, more selective version now circulating in political and legal discourse. The kind that sounds principled until you read the fine print.
The message goes like this: You may choose, just make sure you choose correctly.
It’s the literary equivalent of Animal Farm: …
Artificial intelligence has transformed pharmaceutical science more rapidly than any other part of health care. AI can now:
Recent analyses in Drug Discovery Today and …
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Physician advocate and physical therapist Kim Downey and counselor Shari Morin-Degel discuss their article, “Why burnout prevention starts with leadership.” Shari shares her personal journey from a trauma-exposed mental health professional to …
Every week in clinic, I meet patients who carry lab results like heavy burdens. Their cholesterol is “slightly high,” their thyroid level is “borderline,” or their blood sugar is “just above normal.” They arrive anxious, wanting certainty: Do I need treatment? Am I sick?
The truth is, much of medicine exists in the gray zone (values that are not clearly normal, but not clearly dangerous either).
What the research tells us
Borderline numbers …
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