I didn’t realize how exhausted I was until everything stopped. First came burnout, the quiet unraveling so many physicians know too well. Then grief followed. I lost my mother unexpectedly to an aggressive cancer and, three years later, my father after years of caregiving through advanced Parkinson’s disease. These losses shattered not only my heart but the way I viewed my life and work. For years, I practiced medicine within …
Something is wrong with our health care system. Our country spends more per capita than any other developed nation, yet we have some of the worst health care outcomes. Rising costs are making health care prohibitive. Access to the system is becoming a growing concern. Medical care has become bureaucratic, bulky, and inefficient. I am a retired physician, a urologist, who has observed the health care system from outside medical …
Presidents are not immortal. But for much of American history, their bodies have been treated as state secrets, curated, concealed, and choreographed for public reassurance. When illness is hidden, the cost is not just clinical. It is geopolitical.
Warren G. Harding: collapse before the scandal
President Warren G. Harding died suddenly on August 2, 1923, at age 57, while touring the country on his “Voyage of Understanding.” He collapsed in San Francisco’s …
I put it on one night among tears and grief. It slid onto my skin like butter, like it was meant for me. It hugged my torso and clung to all the wrong places. The truth is, I had worn it before. I am unsure exactly when I last stopped wearing it. Unlike the donning of the letter, the removal is much quieter. I probably did not realize exactly when …
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Physical therapists Kim Downey, Ziya Altug, and Shirish Sachdeva discuss their article “How physicians can reclaim resilience through better sleep, nutrition, and exercise.” In this episode, Kim, Ziya, and Shirish explain how …
The numbers are staggering. Americans made 139.8 million emergency department visits in 2024, that is 42.7 visits per 100 people, with behavioral health issues driving an unprecedented surge. Behind these statistics lies a harsh reality: depression, a leading cause of ill health and disability worldwide, is overwhelming our emergency departments with cases they were never designed to handle. This tsunami of mental health crises creates a vicious cycle. …
(Author’s note: This article has been a year in the making. Each time another mass shooting makes headlines, I think, this is the moment to speak, and then life intervenes. The opportunity to contribute meaningfully feels missed. But the cruelest irony is this: Wait ten more days, and there will be another tragedy to make the conversation relevant again. That, in itself, is the most heartbreaking fact of all.)
“Study my …
Introduction
In a recent episode of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, welcomed Dr. Michael Ast, an orthopedic surgeon specializing in adult reconstruction and joint replacement surgery. Beyond being an accomplished clinician at the Hospital of Special Surgery in New York, Dr. Ast also lectures often on business and career issues, and is especially passionate about teaching younger physicians how to build their practices …
“To practice medicine,” a mentor once told me, “is to live with the tension between what you can do and what you should do.”
I didn’t understand him then. I do now. It is two in the morning in a Chicago hospital. The unit hums with fluorescent fatigue. A man in his fifties lies gasping for air, his lungs crowded by metastatic cancer. His chart lists “full code.” His daughter, sobbing …
Doctors, I like to think, are fairly intelligent people. We worked hard in school, extremely hard in residency, and continue to refine our skills decades into practice. In addition to being intellectual, we are often experts in our fields. We enjoy more respect and higher salaries than most professions. Our work can be humbling and challenging, and it exposes us to the flawed nature of humans. Despite deeply understanding that …
What if the career you spent your life building, the one filled with achievement, purpose, and prestige, is now the cage you cannot escape? That question did not just haunt me; it held me back for years.
I was a successful urologist, specialized in advanced prostate cancer detection, robotic surgery, and men’s health. From the outside, I had it all: a thriving practice, financial security, a respected reputation, and a steady …
As I sit breastfeeding a newborn and hastily switch to pump while the newborn (my fourth child) dozes, I have some thoughts that I think are particularly timely given concerns that are facing millions of families of young children in our country. Maternal and infant mortality continue to be worryingly high in the U.S., especially for women and children of color and in socially vulnerable areas of our country. The …
As a physician, I am trained to diagnose not just the presenting symptom but the underlying pathology. This is the same lens through which many of us in the medical community view the epidemic of American violence. For years, organizations from the AMA to the CDC have called it a public health crisis. This is not merely a metaphor; it is a clinical framework pioneered right here in Chicago by …
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Neurosurgeon Jeffrey Hatef, Jr. discusses his article “Guilty until proven innocent? My experience with a state medical board.” In this episode, Jeffrey shares the shocking story of how his medical license was …
My wife, Kathy, had stage 4 end-stage renal disease. She was slowly dying, but never stopped living. Her resilience in managing peritoneal dialysis made travel possible, even with the logistical complexities involved. Ireland had long been on our bucket list, inspired by Kathy and Stephanie’s earlier visit while we lived in Peoria. With careful planning, we booked our flights using points out of Orlando, knowing the drive would minimize Kathy’s …
When the FOURIER trial was published in 2017, cardiologists and lipidologists everywhere hailed it as proof that lowering LDL with PCSK9 inhibitors “saves lives.” But when you actually read the data, not the press releases, it’s hard not to shake your head.
Over a median of 2.2 years, evolocumab (Repatha) reduced nonfatal heart attacks by about 0.9 percent and had no significant impact on death. The absolute risk reduction for all-cause …
While work-related stress continues to be a major cause of burnout, new research shows that non-work stressors like caregiving demands, financial instability, and personal life conflicts also greatly increase the risk. Yet, the dominant narrative has not caught up, and many still believe burnout is only a workplace problem, overlooking the deeper, life-wide imbalance it often reflects.
Recently, I spoke to a nurse on sick leave for the third time …
Jodie Green and I have been following each other on social media for a couple of years, and we finally had a conversation a few months ago. We discussed our appreciation for the work each of us is doing to support doctors and all other health care professionals, including my efforts and Jodie’s with her organization, the Clinician Burnout Foundation. We’re amplifying meaningful resources that are available for …
In 2025, Canada’s universal health care or Medicare system confronted a stark wake-up call. Many high-visibility service disruptions exposed the health care delivery model’s fragility and stress points. There were emergency room (ER) closures and specialty service interruptions.
In British Columbia, many hospitals repeatedly and increasingly closed their ERs for hours or days due to staffing shortages. The hospitals in large cities like Delta and Mission had multiple separate ER shutdowns. …
I have been representing physicians for over 30 years, and I am still amazed by the attitude of most young physicians going into their first attending position. These are smart, accomplished, fully qualified physicians who have received some of the best clinical training in the world. And yet, many of these highly trained individuals in a field with massive shortages seem reluctant to acknowledge even the slightest modicum of self-worth.
Bear …
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