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Otolaryngologist Alan P. Feren discusses his article “How system strain contributes to medical gaslighting in health care.” Alan explores why encounters that patients experience as dismissive or manipulative often stem from communication …
Systemic strain creates the perfect environment for medical gaslighting [PODCAST]
It was 3:17 a.m. when the trauma pager went off. “Level 1 incoming. MVC. Hypotensive.” The trauma bay shifted instantly from stillness to choreography. Blood coolers opened. Monitors lit up. A resident’s voice tightened as he called out the vitals. The patient was young. Too young. Blood pressure in the 70s. Oxygen saturation falling. The kind of numbers that make the room feel smaller. CT was not ready. Labs were …
In the age of AI, what makes a physician REAL?
I have spent 30 years as a physical medicine and rehabilitation physician in solo practice. In three decades of treating patients, I have witnessed the slow, systematic transfer of health care decision-making from clinicians to people who have never touched a patient.
When I started my career, physicians led health care. Today, private equity firms own hospitals, insurance company algorithms override clinical judgment, and administrators whose primary loyalty is to shareholders …
The cost of clinician absence in the boardroom: a 30-year perspective
At our yearly Christmas medical staff dinner this last year, our chief of staff asked all the doctors present who had been working at our hospital for five or more years to stand up. Quite a few of us rose. He then asked those who had been there 10 years or more to remain standing. After half of us sat down, he upped the ante to 15 years, then to …
An excerpt from Still Life with Stethoscope and Typewriter: Essays and Echoes of Narrative Medicine.
Every Olympic Games eventually produces its own mythology. Not the noble kind, ancient Greeks crowned in olive leaves, but the modern variety, where rumor, technology, desperation, and money form a cocktail best consumed at a safe distance.
The 2026 Winter Olympics in Milan have already delivered one such legend: the claim that elite ski jumpers were …
2026 Winter Olympics rumors: the truth about ski jumpers and hyaluronic acid
“Do no harm.” Upon entering medical school, my classmates and I uttered these words with pride and joy, unaware of the deeper meaning behind them. While it may sound cliché, many of us choose to become doctors because we have a strong desire to help others in some capacity. The esteemed title M.D. fortunately allows us to wear many different hats in serving our communities. Medical doctors have expanded their …
Immigration policy and child health: a medical student’s perspective
A man notices it in a moment he did not plan to analyze.
An erection that used to be straight now bends. There is a new ache. Sex feels different, less reliable, more tense. He tells himself it is temporary. He avoids looking too closely. He stops initiating intimacy. And most of the time, he does not say a word.
That quiet delay is one of the most overlooked parts of Peyronie’s …
Peyronie’s disease symptoms: Why men delay seeking help
These days, it is not uncommon to hear complaints from doctors, nurses, and other clinical staff about policies made by “higher-ups.” Stories of physician burnout, frustration with appointment time limits, and dissatisfaction with policy changes are all too familiar. As a medical student, I have often felt this sentiment that “administration is the enemy.”
However, this past summer, I had the unique opportunity to serve as a medical student business intern, …
Why medical students need health care economics
Toward the end of undergrad, I was desperate for money to support myself and feed my figurative babies, which at the time took the form of MCAT prep and medical school applications. This desperation led to some outside-the-box thinking about how to make ends meet.
One of the most out-of-character things I did was work at Williams-Sonoma. My main motivation for working there was that it was right next to a …
From Williams-Sonoma to medicine: What retail taught me about difficult patients
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Board-certified internist with a long-standing focus on public health, tobacco control, and preventive care Edward Anselm discusses his article “The economic case for investing in tobacco cessation.” Edward reveals that while smoking …
Tobacco cessation offers untapped revenue for medical practices [PODCAST]
In his recent executive order, Ending Crime and Disorder on America’s Streets, President Trump directed federal agencies to utilize forced institutionalization of unhoused individuals under the guise of public safety, lambasting evidence-based harm reduction programs in the process. Unhoused people are framed as threats by Trump, engaging in open-air drug use and vagrancy. In response, the National Homelessness Law Center condemned this executive order and projected even worse outcomes due …
Executive order on homelessness: Why forced treatment fails
For clinicians, trainees, and health system leaders, the referral process is meant to connect patients to the specialty care they need. But in everyday practice, this bridge often feels like a maze. Many of us, whether as physicians in training or practicing providers, have watched patients become lost in delays, miscommunications, and inappropriate specialist visits that worsen outcomes rather than improve them.
The consequences of a broken system
In my own experience …
The medical referral process: Why it fails and how to fix it
There are resilience workshops. Mindfulness apps. Yoga sessions scheduled between clinics. Burnout surveys. Pizza in the call room on Doctor’s Day.
There is nothing wrong with any of these efforts. Some are thoughtful. A few are genuinely helpful.
Yet many physicians feel a quiet unease. A sense that something important is being performed rather than addressed.
I have come to think of this as wellness theater.
By this, I mean programs that signal concern …
Physician wellness theater: Why pizza parties do not fix burnout
Antimicrobial resistance (AMR) is being talked about more now than ever before, and for good reason. When medicines stop working for common infections, everyone loses. The World Health Organization has described AMR as one of the top global health threats, and in October 2025 published data suggesting that in parts of Africa, as many as one in five infections are resistant to commonly used antibiotics.
That statistic should alarm us. But …
Antimicrobial resistance causes: Why social factors matter more than drugs
Every night I spend at home, I wake up to the sound of Für Elise by Ludwig van Beethoven. If you asked my dad, who works remotely, he would grimace and tell you he hears it at least 10 times a day. It’s a classic piano piece, don’t get me wrong, but we don’t have a piano, nor are we a family of Beethoven fanatics. My dad probably loved Beethoven …
Immigrant caregiver burden: the hidden cost of the five-year Medicaid wait
Today’s clinicians are spending more time documenting care than delivering it. This reality is not lost on health care providers, many of whom feel burnt out and unfulfilled by this overwhelming administrative burden. The digitization of health care, which once felt like a promise of efficiency, has pulled clinicians away from patients and toward screens. The problem isn’t technology itself; it’s the result of poorly designed siloed solutions and disconnected …
Connected health care workflows: From chore to core patient care
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Family physician Kelly Bain discusses her article “Why physician business literacy matters.” Kelly explains that while doctors are trained to diagnose and treat patients, they are rarely prepared to navigate the complex …
Business literacy empowers physicians to lead sustainable health systems [PODCAST]
We are born into corridors,
measured, labeled,
painted neutral,
walls rising before we learn how wide
our thoughts can stretch.
Lines are drawn early:
This is far enough,
this is acceptable,
this is where you stop.
We are told our ideas must sit quietly,
folded into boxes like unused maps,
that imagination is dangerous if it wanders,
that questions should behave
and answers should already be known.
Life, they say, is safest when it stays
inside the margins.
But something restless stirs
beneath the rules.
A pulse.
A whisper …
The necessity of getting lost to find yourself
Medicine has always loved the story of the hero.
The physician who pushes through exhaustion. The one who catches the rare diagnosis at the last second. The colleague who seems to carry an impossible load without ever dropping the ball.
But after years of watching which physicians actually thrive, not just survive, I have come to believe we have been telling the wrong story.
The doctors who perform at the highest level over …
Physician resilience: Why systems matter more than heroism
My wife underwent major surgery in December 2025. She remained 10 days in a Charlotte, NC, hospital and was then for several weeks supported at home by visiting nurses, a physical therapist, and a dietician. We just saw the bill: The hospital and participating doctors submitted bills of $120,000 to Medicare and to Tricare (family health insurance for military service veterans like me).
The 21 years that I served as a …
Medical bankruptcy: the hidden cost of U.S. health care
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