She was pale, underweight, fifty years old and scared. Mrs. G was a breast cancer patient on the oncology unit whom I met by chance, as she appeared on my patient census list that morning. As I walked into her room, I noticed the fragrant flowers, the cards scattered about her hospital tray, and the numerous pictures of her friends and family that attempted to bring her peace and …
Breast cancer was never supposed to be part of my story
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Surgeon and author Jeffrey A. Singer discusses his article “The FDA’s outdated prescription rules are failing women and opioid users.” He argues that the U.S. Food and Drug Administration’s requirement for prescriptions …
Why the FDA’s outdated prescription rules hinder access to birth control and naloxone [PODCAST]
Artificial intelligence (AI) large language models (LLMs) and the systems based on this technology have recently emerged onto the medical scene with huge promises to “disrupt” and innovate upon traditional clinical practice. Ignoring the hype and boom-bust adoption cycles associated with most novel technology, AI will eventually settle into the daily workflow of many physicians, be it through direct use, or indirectly, through integration within EMRs, insurance approval pipelines, or …
Medical school admissions are racing toward an AI-driven disaster
Increasingly, it’s showing up in people in their 20s and 30s—individuals who don’t drink excessively, don’t appear outwardly unhealthy, and often have no idea their liver is under stress. The condition, now referred to as metabolic dysfunction-associated steatohepatitis (MASH), is emerging as a quiet epidemic, and diet and gut health are playing a larger role than many realize.
As a gastroenterologist, I’ve observed a shift in the demographics …
Fatty liver disease is no longer reserved for older adults
The actions taken by the Medical Board against a compassionate physician dedicated to alleviating chronic pain are nothing short of egregious, deeply flawed, and emblematic of a system that seems intent on punishing rather than protecting. This esteemed doctor, who has spent years serving patients in dire need with integrity and professionalism, now finds himself ensnared by a process that appears more vindictive than just, more biased than fair.
The silent crisis hurting pain patients and their doctors
I stood at the check-in counter of my physician’s office, waiting for my yearly physical. Beside me, another patient was checking in. I recognized her instantly.
It was Denise—my childhood best friend.
And yet, I couldn’t bring myself to say hello.
We had spent our childhoods side by side—playing Barbies, cheerleading, swimming at the neighborhood pool. Every single day. She wasn’t just a friend; she was my safe place. We stayed close all …
What money can’t fix: the scars left by a friend
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Health care executive Gavin Magaha discusses his article “Advancing drug discount programs starts with collaboration and clarity.” He outlines how the 340B drug discount program, established over 30 years ago, has not …
Reforming the 340B drug discount program through data, clarity, and collaboration [PODCAST]
In recent years, psychiatric care has undergone a shift in the clinical mindset toward medication management for people living with schizophrenia and other chronic mental health conditions. As recognition grows for the breadth and depth of the clinical complexities and psychosocial challenges that patients may face along their diagnostic and treatment journey, there is movement toward ensuring that patients have access to treatment options that integrate their needs and preferences. …
Why long-acting injectables are transforming schizophrenia care
I’m in this place of noticing—not reacting—simply noticing the dance between myself and my environment, in the clinical setting and beyond.
I’m noticing myself in conversation with colleagues. I’m asking the tough questions I hadn’t thought to ask before: Do my thoughts, ideas, and opinions truly contribute to moving the conversation forward? Do they actually help shape the actions needed to reach the end result?
As physicians, we often believe they do. …
The quiet shift: Practicing presence in the fast-paced medical profession
The health, judicial, and socioeconomic disparities among ethnic minorities are pervasive, and vaccination rates are key among them. The inequities among marginalized groups are largely driven by social determinants of health, education, and access to care. The United States has a well-documented history of these inadequacies, strengthened even further by the COVID-19 pandemic in 2020, leading to higher mortality and …
Why vaccine access still fails America’s most vulnerable groups
I read with great interest the recently published article in The New York Times by Paul Tough, who has reported on child development and education over the last twenty years. He outlines statistics, specifically the rise in diagnosis of children and adults since the 1990s, and then discusses implications, including questioning a current understanding of the disorder and its treatment.
Neurodevelopmental disorder
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder …
ADHD isn’t one-size-fits-all: Why nuance in diagnosis matters
For the past 30 years, I’ve witnessed medicine evolve—new technologies emerge, new treatments are developed, and wellness programs are implemented—but one thing remains stubbornly unchanged: the relentless, often destructive, quest for validation. As I reflect on my career, I can’t help but see a parallel with the TV series Severance, where employees’ work selves—their “innies”—are literally separated from their personal lives—their “outies.” In our profession, our innie is the part …
Why chasing validation is destroying physicians’ sense of self
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Pediatrician and certified coach Jessie Mahoney discusses her article “How to get physician wellness programs funded: a proven path forward.” Drawing on nearly two decades of experience navigating institutional hurdles and five …
Funding physician wellness: a guide to getting programs approved [PODCAST]
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Adapted from Greed to Do Good: The Untold Story of CDC’s Disastrous War on Opioids.
The 2016 CDC opioid guideline seemed to make obvious sense: Americans were consuming far too many prescribed opioids. Many users of illicit opioids reported that prescribed opioids had been their gateway to illicit usage, even addiction. And users of illegal opioids, whether addicts or not, were dying of overdoses—more and more each year. The prescription …
How the CDC’s opioid rules created a crisis for chronic pain patients
For many physicians, the word “negotiation” conjures up stress.
Most of us weren’t taught that negotiation is something we do every day—at work, at home, and in nearly every human interaction. Whether we’re persuading a patient to change a behavior, deciding on a restaurant with a partner, or navigating parenting decisions, we are constantly negotiating. Many physicians—especially women physicians—find negotiating extremely uncomfortable.
Why?
Because …
Why physicians find negotiating challenging—and what they can do to negotiate better
Kobe Bryant’s impact on my life and career stretches far beyond the basketball court. The essence of his spirit—his commitment to excellence, his relentless pursuit of mastery, and his unyielding work ethic—has inspired me not only in the game of basketball but in the field of medicine as well.
Kobe came into my life as Michael Jordan was leaving the game. While I was fortunate enough to witness the latter half …
A tribute to Kobe Bryant: inspiration beyond the game
Leadership in any industry, especially in health care, demands a delicate balance of trust, ethical judgment, and professionalism. However, when leaders view collaboration through a lens of suspicion, assuming that employees are conspiring against them, it can lead to a culture of distrust and unprofessional behavior. This article delves into the psychological and ethical aspects of such behavior, its impact on workplace dynamics, and practical strategies for navigating these challenging …
When leadership turns defensive: the impact of workplace paranoia on professionalism
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Health care executive Jeffry A. Peters discusses his article “Ending physicians’ addiction to unhappiness,” focusing on the systemic factors fueling widespread dissatisfaction among doctors. Jeffry outlines how declining reimbursement, increased patient volume, …
How to build a culture where physicians feel valued [PODCAST]
Amidst the recent news about the murder of UnitedHealthcare CEO, the issue of prior authorization has come to the forefront again. Insurance companies use prior authorization as an easy tool to control the costs and incorporate it as a genuine step of the health care delivery process. The recent trend is to use AI (artificial intelligence) for prior authorizations. AI offers several advantages over human workers, further saving time and …
AI in health care: the black box of prior authorization
Unless you’ve lived it,
you can’t fully understand.
We’ve all cared for patients with cancer. We’ve delivered hard news, sat beside bedsides, explained scan results, and offered hope when we could. We’ve been the calm in the storm. That’s what we were trained to do.
But being on the other side of the table changes everything.
When you become the patient, the world shifts beneath you. Suddenly, you’re the one in the gown, lying …
From the other side of the table: a plea for empathy
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