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Internal medicine physician Corinne Sundar Rao discusses her article “Physician on-call compensation: the unpaid labor driving burnout.” Corinne argues that the term “call” is a euphemism used to extract free labor from …
Unpaid on-call shifts are driving doctors into early retirement [PODCAST]
I first learned to respect silence over a chessboard. Two players sit across from one another, the clock ticking audibly, 64 squares holding more possibility than certainty. You arrive, survey the position, and wait. You gather information, recall principles, recognize patterns, and only then commit, knowing that every decision constrains the future in ways you cannot fully predict.
Now, as a third-year medical student on clinical rotations, I find myself standing …
What chess taught me about clinical reasoning and humanism
I never imagined that providing standard, evidence-based medical care, and explaining that care clearly to patients, could put me at risk of federal prosecution.
Yet that is the position I find myself in today.
I am a board-certified family medicine physician and the founder of a small queer- and trans-owned clinic providing gender affirming care. Our clinic is now at the center of a Department of Justice appeal after we Read more…
Physician free speech rights under fire: the DOJ vs. patient education
He came in wanting to get his smile back. I did not know he was also asking for his life.
He sat down in my chair and did not say much at first.
That happens a lot in a MassHealth practice in Massachusetts. People come in with more than just one problem. They carry shame, years of avoiding problems, and a lifetime of being told by systems, situations, and sometimes even their …
Treating methamphetamine-associated dental disease in safety-net clinics
In my first week of anesthesiology residency at the Hospital of the University of Pennsylvania, I learned two things at once: how to keep other people breathing and how it feels to lose your own air. My chest filled with liters of lymphatic fluid. A scan showed lungs that looked like lace. The diagnosis was LAM, lymphangioleiomyomatosis, a rare, estrogen-sensitive lung disease that overwhelmingly strikes women in their reproductive years.
At …
Reproductive care for rare diseases: the missing playbook
“Overdiagnosis is a myth that has been created by a handful of individuals who provide no care for women with breast cancer.”
This quote by Dr. Daniel Kopans encapsulates a long-standing and intense debate in the medical community regarding cancer screening.
In the Dec. 9, 2025, issue of the New York Times, Gina Kolata quoted H. Gilbert Welch, MD, on his perspective that “treatments need to be balanced with the consequences …
The myth of cancer overdiagnosis: Why screening saves lives
Medical innovation is often framed as something that begins once a product is built, tested, funded, and approved. But anyone who has spent time in medicine or biomedical research knows that is the farthest thing from the truth. Innovation usually starts much earlier with a moment of frustration, a recurring inefficiency, or a quiet realization that something in patient care could work better.
What’s less clear is how we’re supposed to …
Early-stage medical device innovation: How to discuss untested ideas
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Family physician and health benefits advisor Jonathan Bushman discusses his article “The 5 percent problem: the low value of primary care.” Jonathan contrasts the grueling decade of training and massive debt required …
Primary care receives only five cents of every health care dollar [PODCAST]
Across the United States, rural maternity care is in crisis. Hospitals continue to close labor and delivery units, entire counties are left without obstetric services, and pregnant patients are forced to travel hours for routine care or delivery. These closures are often framed as inevitable, driven by low volume, unsustainable costs, and staffing shortages, but this narrative ignores both the root causes of the problem and the solutions already within …
Rural maternity care in crisis: 5 solutions to save local OB units
I’m Tommy. Bipolar type one, I’m told. I actually have something to say, something to share.
The thing no one talks about in mental health, bipolar type one specifically, is how seductive and sweet the upswing feels. It’s deeply more than just “good” to me. It feels like the limits of the brain have been cut loose, severed, done away with. Suddenly all those moments and ideas and thoughts and connections …
Bipolar I and the illusion of insight: a firsthand account
Once upon a time, clinicians didn’t have enough data about their patients.
To put it mildly, things have changed. Today we’re drowning in data. As a practicing emergency physician, it is a reality I see every day.
In an emergency department (ED) environment characterized by constant time pressure, staffing constraints, and high patient acuity, clinicians sometimes must wade through reams of electronic health records (EHR) data to find critical patient information that …
AI in health care data management: Curing the EHR overload
I have spent my career believing in systems. As physicians, we are trained to trust oversight. We are taught that regulatory bodies exist to protect patients, maintain standards, and intervene when care falls below acceptable levels. We are taught that if we act ethically, document carefully, and prioritize patients, the system will ultimately be fair. What we are not trained for is what happens when that power becomes opaque.
Over the …
The hidden toll of physician regulatory investigations
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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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