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Internal medicine physician and author Robert C. Smith discusses his article, “Medicine’s mental health crisis: why the system is failing us.” He reveals the shocking disparity in care, where only 25 percent of patients with mental illness receive any treatment compared to 70 percent for …
That was one of my uneventful night duties—until early morning. As usual, I had a hectic on-call day, where I barely got half an hour for dinner—which we consider routine. Around 3 a.m., I received a request for an abdominal CT scan for a middle-aged male patient with abdominal pain. The surgeons were suspecting mesenteric ischemia—blockage in abdominal vessels, which can be life-threatening.
I glanced through the scan, trying to open …
When I began the journey to becoming a doctor, I believed success was a destination—a finish line I’d reach if I just worked hard enough, studied long enough, and sacrificed deeply enough.
And I did all those things.
I pushed through sleepless nights in college. Carried the weight of relentless pressure in medical school. Survived the grind of residency, where time lost all meaning. I lived with my eyes fixed on the …
What is psychotherapy?
Psychotherapy is a talking process between a patient and a psychotherapist. Psychotherapy makes connections among feelings, thoughts, impulses, and behaviors to understand what works and what gets in the way of meeting life’s goals, reaching one’s fullest potential, feeling successful, and being fulfilled. This is accomplished by self-reflection. By examining life patterns, changing, improving, and unlearning emotional and behavioral habits that get in the way and are no …
President Trump signed into law the One Big Beautiful Bill Act (H.R. 1)—a 1,000+ page legislative thunderclap that had just cleared Congress, reshaping the landscape of American domestic policy as fireworks lit the sky. Branded as a domestic reset—heavy on tax cuts, defense expansion, and deregulation—it was not sold as a health care bill. But for those of us on the front lines of medicine, particularly in rural America, make …
The mouth is connected to the body by blood vessels, lymphatic pathways, and the immune system. Ignoring oral health means risking more than a toothache — it could mean risking your life.
When most people think of oral health, they think of teeth, cavities, brushing, flossing, maybe the occasional root canal. But the truth is, what’s happening in your mouth can have a ripple effect throughout your entire body. This is …
In the realm of American politics, discussing the mental fitness of a sitting president – or the performance of a former one – is as delicate as it is critical.
As a psychiatrist, I am profoundly aware of the ethical constraints outlined by the Goldwater Rule, adopted by the American Psychiatric Association (of which I am a Fellow). Psychiatrists’ ethical responsibility is to refrain from making specific clinical diagnoses without Read more…
Most people don’t read their medical bills—they panic over them. After all, receiving a multi-page statement full of confusing codes, unexplained charges, and unclear payment instructions isn’t just frustrating—it’s intimidating. I’ve worked with countless individuals who feel helpless in the face of these documents, unsure of what they owe, why they owe it, or whether the charges are even correct.
This confusion isn’t just common—it’s systemic. As a patient advocate and …
When people think of Botox and filler, they think of vanity. Frozen foreheads. Pouty lips. Women chasing youth. Injectors chasing cash. They don’t see the woman who finally escaped her husband after 20 years of abuse, coming in not for attention but for control. They don’t see the mother burying her child, hoping that looking “normal” on the outside might steady the chaos inside. They don’t see the cancer survivor …
Menopause is finally having its moment in the spotlight, thanks to high-profile women breaking the long-standing taboo around discussing this life stage. Yet, while discussions around hormone replacement therapy (HRT) have increased, one critical component remains largely overlooked — testosterone.
Traditionally seen as a “male hormone,” testosterone is equally vital for women’s health, playing a key role in mood, energy, libido, muscle mass, bone density, and cognitive function. Yet, …
I do not fear artificial intelligence—nor do I revere it. What I feel toward the rise of intelligent systems in medicine is something quieter: a tempered trust, a measured hope. I recognize their immense potential, but I also hold firm to the belief that the deepest work of medicine happens not through automation, but through human connection. There is a quiet power that lives between symptom and story, between numbers …
In the face of worsening health workforce shortages, Canada must shift from a culture of personal likability to a system of objective qualifications or merits in recruiting and retaining physicians. While team cohesion and interpersonal compatibility are essential, an overemphasis on “fit” or likability excludes talented physicians, particularly immigrants and racialized minorities, who may not share the cultural background, communication style, or social behaviors preferred by decision-makers. This practice undermines …
Veterans deserve the highest-quality health care our nation can offer, but fulfilling this promise often means overcoming major challenges. About 9 million veterans receive care through the VA, with a third living in rural areas far from VA facilities. Meeting their needs requires innovative solutions that combine expertise, technology, and strategic partnerships.
Why VA’s holistic model outpaces traditional care
The VA stands apart with its integrated, long-term approach to care. Unlike the …
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Judgment pervades medicine—of patients, colleagues, and ourselves.
We’re trained to judge, disguised as caring, standards, and competence. It’s seen as essential to being a “good physician.” We do it so instinctively, we rarely question it.
But we should.
The culture of judgment in medicine
Judgment is baked into our training: The scrutiny of rounds, the competition of grades, the pressure of evaluations. It’s in our language: “noncompliant,” “failure to thrive,” “incompetent cervix.” Even our …
When I was a medical student, some enterprising classmate started a note taking service so we wouldn’t have to take notes on our own. He set up a tape recorder and transcribed the notes for distribution the next day. One day, our professor showed up with a tape recorder, set it up on the table in front of the lecture hall, and turned it on. The result was an electronic …
“Why do you want to be a doctor?”
Ask any pre-med that question, and you’ll probably hear the same answer: “I just want to help people.”
I’ve said it, too—more times than I can count. But lately, I’ve started to question what that phrase even means. Not because I’ve lost faith in medicine, but because I’ve learned that helping is more complex, layered, and humbling than I ever imagined.
As the host of …
In this era of digital revolution in health care, the traditional physician-patient relationship is undergoing a significant transformation. Digital tools, including telemedicine, electronic health records (EHRs), artificial intelligence-based diagnostics, and various fitness applications, are reshaping how patients and clinicians interact and manage health together. While these innovations surely provide efficiency and accessibility, they also present significant challenges to the fundamental aspects of medical practice: trust, empathy, and human connection. As …
In the current complex health care landscape, health care leaders are frequently challenged to make management decisions that are effective but also equitable. Numerous leadership transitions are occurring in Canada’s health care systems because of leadership failures. In British Columbia, multiple health care leaders were replaced in the first half of 2025. David Eby, British Columbia’s Premier, declared, “The anxiety that I have is that the people who see the …
Health care leaders don’t have a vision problem. We have an execution problem.
Over the last two decades, I’ve seen countless strategic plans crafted with care, insight, and bold ambition. Mission statements get refreshed. Core values are realigned. Retreats are held. Vision decks are created and shared from the C-suite to the frontlines. And yet — within weeks — most of those plans fade into the background.
The problem isn’t poor leadership …
The residency match process is one of the most defining and often most daunting milestones in a medical student’s journey. It represents the culmination of over eight years of dedication, sacrifice, and hard work in pursuit of a dream many of us have nurtured since childhood.
Building a strong application is challenging for everyone. Whether you’re navigating personal doubts, managing financial strain, lacking mentorship, or simply trying to figure out the …
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