An excerpt from Self-Awareness and Trust: Leading Healthcare Teams from the Inside Out.
“Knowing yourself is the beginning of all wisdom.”
– Widely attributed to Aristotle
I had been away from the intensive care unit (ICU) for a couple of weeks. When I came back for a scheduled week of service, I put on my black fleece jacket (the same one I had worn hundreds of times before). As I slid my …
Physician presenteeism starts with a dangerous myth
During my time as a registered nurse, I once cared for a woman in her late fifties (with identifying details changed) who had spent nearly a year adapting to symptoms she never thought signaled something serious: body aches, fatigue, frequent nighttime urination, constant thirst, breathlessness, and headaches. Each time the pain flared, she visited a local clinic, received an injection, felt better within hours, and returned to her life. Weeks …
The quiet beliefs that lead to a delayed diagnosis
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A tech founder used one pediatrician’s public advice to train her own AI. Sonal Patel decided doctors should own the tools built on their knowledge instead. Patel is a pediatrician and neonatologist who built and controls her own AI for the fourth …
Who should own the AI that doctors built [PODCAST]
I grew up in the western suburbs of Chicago as the youngest of three boys. I experienced deep depression and suicidality at nineteen, after a childhood of anxiety that often left me paralyzed and physically sick. I was treated by an amazing psychiatrist and started on Prozac, which flipped me into mania. I had underlying bipolar I disorder, and substance-induced mania is not uncommon with it. My older brother shares …
Mental health stigma in medicine silences physicians
A study in JCO Oncology Practice surveyed 542 oncology professionals across 55 countries on exactly this overlap. The numbers are stark: 56.1 percent met criteria for burnout, 34.1 percent had high impostor phenomenon scores, and 38 percent were identified as maladaptive perfectionists. The lead author, an oncology fellow who began the project after recognizing the pattern in his own career, didn’t mince words about what he found, saying, “The findings …
Why imposter syndrome and burnout share a circuit
An excerpt from One Pocket.
I reported to Walter Reed Army Medical Center on August 25, 1969. The complex was in Bethesda, Maryland, about thirty minutes from the White House. Founded in 1909, it had cared for every president of the United States, along with members of Congress and the Supreme Court. It had 1,122 hospital beds and treated more than 750,000 patients a year.
I was assigned as a medical …
Finding purpose in patient care after a wartime injury
As a pain specialist who manages cancer-related pain daily with both interventional and non-interventional approaches, I still encounter a frustrating reality: Too many patients suffer longer than necessary. Recent data show that roughly 44.5 percent of patients with cancer experience pain, and about 30 percent report moderate-to-severe intensity. While prevalence has declined modestly over the past decade, the absolute burden remains high, especially in advanced disease and among survivors living …
Multimodal cancer pain management starts with assessment
A radiologist flags something on a scan that shouldn’t be there. The physician sends a referral to oncology that same day, the kind where a few weeks genuinely matter, not the kind you let sit in a queue. The system logs it, and the chart shows it as clean and complete: sent.
Four months later, at a visit for something unrelated (a sore shoulder, nothing serious), the physician asks how the …
Closed-loop referral management needs a defined owner
One morning after finishing surgery, my nurse pulled me aside. “You need to get into Exam Room One,” she said. “He’s in bad shape.”
Curled up on the floor was an active-duty Navy SEAL. His girlfriend knelt beside him, rubbing his back as he rocked back and forth in pain. A military backpack leaned against the wall. When he looked up at me, tears streamed down his face.
“Doc,” he said between …
What kidney stone pain taught me about human suffering
We’ve all taken a leap of faith at some point in our lives. For me, it was switching from a traditional physician’s practice to joining CenterWell Senior Primary Care, which employs a true team-based approach. Doing so has convinced me that it’s one of the best methods for keeping my patients healthy …
Taking a leap of faith in my career was the best thing for my patients and me
An adverse peer-review determination is one of the most consequential events in a physician’s professional life. When a hospital revokes clinical privileges or imposes a suspension exceeding thirty days, federal statute mandates a report to the National Practitioner Data Bank (NPDB).
In today’s consolidated health care landscape, an adverse NPDB report is an indelible mark with near-insurmountable consequences. It frequently triggers reciprocal investigations by state licensing boards, prompts malpractice carriers to …
Reforming hospital peer review requires independence
“I just don’t feel well,” she says. “I’m tired all the time.”
The patient is sitting across from you in clinic. She struggles to describe exactly what is wrong. There is no specific pain. No new shortness of breath. No fever. Nothing that immediately points you toward a diagnosis. It is a vague and broad symptom, almost an enigma.
You turn toward the computer screen. The laboratory results are reassuring. Most of …
Persistent symptoms despite normal labs deserve attention
During my first few months as a newly minted primary care physician, I spent many weeknight evenings negotiating with myself. The negotiation was always the same. If I close three more notes, I’ve done enough to go home for dinner. Enough to have earned it.
I knew, while making the deal, that “enough” was a fiction, because after dinner I’d open the laptop again and work until the work was done, …
AI scribes save 16 minutes, not your evenings
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Your doctor may help you live longer, but has likely never asked if intimacy still matters to you. In this episode, Michael Reed, a board-certified obstetrician-gynecologist, certified menopause practitioner, and fellowship-trained cosmetic gynecologic surgeon, explains why so many women are never given …
Why your doctor never asks if intimacy still matters to you [PODCAST]
A few years ago, in a clinical trial my colleagues and I ran, something happened that I still find myself thinking about. We asked postmenopausal women who were having frequent, disruptive hot flashes to change one thing: their diet. They shifted to a low-fat, plant-based pattern with a serving of soybeans each day. We weren’t testing a drug or a hormone. We were testing food.
After 12 weeks, moderate-to-severe hot flashes …
What menopause reveals about the body as a network
Research retractions are not all misconduct, and a leaderboard is not a verdict. The Retraction Watch database leaderboard, updated August 2026, shows researchers with dozens or hundreds of retractions but also cautions that its ranking is unofficial and shaped by what can be verified. Its treatment of the landmark 1980s case involving a Harvard University cardiologist illustrates why raw counts require context. Nonetheless, these cases expose recurring vulnerabilities that every …
7 lessons from research retractions about integrity
A patient records request arrives the way a supply order does. It comes in by fax, portal message, or across the front desk, and joins a queue behind every task with a patient sitting in a room. Two federal rules attach the moment it arrives, each on a different clock, and neither is enforced by the practice management system.
The result is a workflow most independent practices cannot describe in numbers. …
How to manage patient records requests and reduce delay
A few days ago, while covering a four-day stretch of on-call shifts, I was asked to step down from my usual role as a psychiatry registrar to cover a vacancy in the senior house officer rota. I have been in the United Kingdom for almost two years now, but during that time I have worked almost exclusively in community psychiatry. Although I had previously worked in inpatient psychiatry in Malaysia, …
Psychological safety in medicine starts with a text
One morning, a new alert showed up in our charts. Just a colored banner. Nobody told us what data it learned from, who it had been tested on, or what we were supposed to do when it went off at 3 a.m. on a patient who looked fine. We were expected to act on it anyway.
We were trained to pick apart a study and question a drug rep. Then software …
AI tools in health care are cleared, not proven to work
What if one of the most effective health care interventions wasn’t a medical treatment at all, but a set of pots and pans?
That may sound surprising, but it captures an important lesson from New York’s Medicaid 1115 waiver, one of the country’s most ambitious efforts to address social needs as part of health care. In Staten Island, the results suggest that improving health sometimes starts far outside a doctor’s office.
Health …
Social determinants of health start outside the clinic
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