It was March 9, 2026. I remember the moment vividly. I woke up with a mix of excitement and hope, about to open the email that would determine whether I had matched into residency. Deep down, I believed I had done everything right. During my external rotations, I gave more than 100 percent. If I was asked for one thing, I delivered two, and I made sure they were done …
Failing the residency match: What I learned from not matching
“What is that?” I was sitting in the emergency room during my emergency medicine rotation, chatting with my attending when he had asked me what residency program I was in. I told him I was actually doing two: family medicine and preventive medicine. Family medicine he had heard of, but preventive medicine? Only a confused look. And he is not the only one. In medical school, there was no specialty …
Why the U.S. needs more preventive medicine and public health doctors
One of the most damaging patterns in health care is also one of the most accepted: delayed diagnosis.
What stays with me is not only the diagnosis that came too late. It is everything that happened before it. The months. Sometimes the years. The symptoms that were minimized, misread, or explained away. The patient who was still struggling, but without enough clarity to move care forward. The family trying to function …
The hidden costs of delayed diagnosis and diagnostic ambiguity
As physicians who regularly work with pediatric patients, and experts in counter-terrorism, we know firsthand the dangers that online radicalization poses to youth. Nihilistic violent extremism (NVE), which glorifies violence for the sake of violence, is on the rise globally. Many of these decentralized online networks, such as the 764 Network, specifically target children for recruitment. 764 has seen a sharp increase in popularity, and has become the …
The true crime community is radicalizing kids online
Once the lockdowns from COVID-19 began, a new normal of distrusting America’s public health officials started. Dr. Anthony Fauci quickly became the most famous and controversial physician in America. At the start of the pandemic, having the responsibility of communicating information and data with the entire country, his advice was trusted by most Americans; a Kaiser Family Foundation survey showed that in December 2020, 90 percent of Democrats and …
Why the doctor-patient relationship survives when trust in public health fails
An excerpt from The DNA of a Doctor: How Upbringing, Culture, and Unbridled Ambition Curates Achievement.
Having the support of male colleagues and mentors was not new to me. I could not have gotten through plastic surgery residency without my male co-residents. Being the only woman in my class and the classes I was sandwiched between could be daunting. My male co-residents were a blessing, they looked after me, and …
Navigating medical training and residency as a female plastic surgeon
Recently, my mother was told by her doctors that her high blood pressure was a concern and that she needed to make dietary changes and eat foods lower in sodium. Seemed simple. To my mother, what was clear was the need for significant dietary change to stay below 2,300 mg of sodium, the recommended limit by the American Heart Association. Sure, she would make sure to not eat food overpowered …
Why cooking for better health makes dietary changes easier
Technology can be intimidating, especially when you do not fully understand how it works. There is also a fear that technology will start taking over and people will lose their jobs. I was one of those people who feared technology, and I kept hearing how artificial intelligence (AI) would take over health care jobs and replace certain roles. I was dead-set against AI being used in health care because I …
Overcoming the fear of health care AI in data abstraction
When asked by the surgery department chair as a medical student why I wanted to treat vascular patients, my response was to be useful, useful to people with a challenging systemic disease that often results in stroke, amputation, and death. Often, wounds that have not healed for months on a foot or a hand, or persistent leg pain provoked by walking or simply laying in bed are subtle indicators that …
Why local care matters for peripheral arterial disease
Recent federal cuts to how Medicare pays physicians are likely to deliver significant negative consequences to independent medical practices.
The Centers for Medicare and Medicaid Services’ (CMS) final rule for the 2026 Medicare Physician Fee Schedule imposes a dramatic reduction in payment rates for medical services performed in hospital settings by independent clinicians.
The payment reduction fails to account for the true resource costs incurred by independent physician practices, creating an …
Medicare practice expense cuts will hurt patients
The community of Tumbler Ridge, B.C. is living through an unimaginable grief. As we mourn with them, we are right to ask what we can learn from this tragedy.
Much of the public conversation has focused on OpenAI: Why did the company not warn police when its systems flagged Jesse Van Rootselaar’s account for violent content months before the shooting? B.C. Premier Eby noted the company’s silence was “profoundly disturbing” …
The urgent need for AI mental health regulation after Tumbler Ridge
This past weekend, I completed the United Airlines NYC Half Marathon, a 13.1-mile course running across the Brooklyn Bridge, through the streets of New York, through Times Square and Central Park, finally finishing upright and with both shoes still on. In the 48 hours since crossing the line, I have reflected deeply on the experience and arrived at one inescapable conclusion: It was still better than going to work. Please …
13.1 reasons running a half marathon beats practicing medicine
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What happens when a doctor closes the chart but the patient leaves without understanding what was actually said? Retired surgeon, independent physician, health care consultant, and patient advocate Alan …
His mother-in-law heard “cancer,” went home, and was dead within a year [PODCAST]
In one health care organization, a provider was reviewed and cleared through routine payment integrity processes. Months later, that same provider became the subject of a fraud investigation, based on patterns that had been present all along. Both reviews were technically correct within their scope. But together, they revealed something more concerning: The system itself was not aligned. Health care organizations invest heavily in payment integrity (PI) and special investigations …
Why health care fraud detection requires payment integrity alignment
A healthy, 4-year-old girl was brought to the pediatric dental office for treatment of several cavities. The parents were told their child would be given medication to help her “sleep” through the procedure. Easier and quicker than going to a hospital, office-based dental sedation was presented as a safe, routine option for children.
After the sleeping medication was administered, the child grew quiet and became still. The dental work began. At …
The hidden dangers of dental sedation and dental anesthesia in kids
Bree is an 11 1/2 year-old, 4.2-pound micro mutt who once lived on the streets of Long Beach. She eventually wound up at Long Beach Animal Care Services, where she sat in a crowded cold cement kennel with no bed, no blanket, no toys, and one very sick basset hound with parvovirus. Every dog in that kennel was scheduled to be euthanized on Christmas Eve 2014. If it weren’t for …
What a tiny dog taught me about the nervous system
Most health care startups don’t fail because the technology is bad. They fail because of mistakes that happen long before the product ever reaches a clinical setting. After seven years of evaluating health care companies as a physician-scientist turned venture investor (and making over 20 investments across digital health, biotech, medical devices, and therapeutics), I’ve started to see the same patterns repeat.
These aren’t obscure business school failures. They’re patterns that …
5 patterns behind health care startups that fail
For more than a decade, the phrase “ultra-processed food” has functioned as nutritional shorthand for danger, a dietary villain blamed for rising rates of obesity, diabetes, and heart disease. The public message has been simple: If it is ultra-processed, avoid it. But science is rarely that simple.
My colleagues and I recently reviewed the growing body of research examining ultra-processed foods, not as a single monolithic category, but as distinct …
Rethinking nutrition policy on ultra-processed food
I first met Ramon in the aftermath of Hurricane Katrina when I was moonlighting in local ERs and assisting wherever needed. New Orleans has a long-standing historical and economic connection to Honduras, primarily through the banana trade and shipping routes linking Honduran ports to New Orleans. These routes facilitated both commerce and migration between the two. Ramon, whose family has deep roots in both Honduras and New Orleans, arrived here …
Preparing for Medicaid cuts and the imperial health boomerang
Late at night, after basketball games or practices, with the physical exhaustion of the court still settling in, I often find myself staring at my laptop. I am watching how long it takes to complete something that has nothing to do with sports, or even actual patient care. It is documentation. Coding. Forms. Insurance language that seems designed less for clinical clarity than for mere survival within a bureaucratic system.
In …
Why accountability in medicine must guide health care AI
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