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Board-certified internist with a long-standing focus on public health, tobacco control, and preventive care Edward Anselm discusses his article “The economic case for investing in tobacco cessation.” Edward reveals that while smoking …
Tobacco cessation offers untapped revenue for medical practices [PODCAST]
In his recent executive order, Ending Crime and Disorder on America’s Streets, President Trump directed federal agencies to utilize forced institutionalization of unhoused individuals under the guise of public safety, lambasting evidence-based harm reduction programs in the process. Unhoused people are framed as threats by Trump, engaging in open-air drug use and vagrancy. In response, the National Homelessness Law Center condemned this executive order and projected even worse outcomes due …
Executive order on homelessness: Why forced treatment fails
For clinicians, trainees, and health system leaders, the referral process is meant to connect patients to the specialty care they need. But in everyday practice, this bridge often feels like a maze. Many of us, whether as physicians in training or practicing providers, have watched patients become lost in delays, miscommunications, and inappropriate specialist visits that worsen outcomes rather than improve them.
The consequences of a broken system
In my own experience …
The medical referral process: Why it fails and how to fix it
There are resilience workshops. Mindfulness apps. Yoga sessions scheduled between clinics. Burnout surveys. Pizza in the call room on Doctor’s Day.
There is nothing wrong with any of these efforts. Some are thoughtful. A few are genuinely helpful.
Yet many physicians feel a quiet unease. A sense that something important is being performed rather than addressed.
I have come to think of this as wellness theater.
By this, I mean programs that signal concern …
Physician wellness theater: Why pizza parties do not fix burnout
Antimicrobial resistance (AMR) is being talked about more now than ever before, and for good reason. When medicines stop working for common infections, everyone loses. The World Health Organization has described AMR as one of the top global health threats, and in October 2025 published data suggesting that in parts of Africa, as many as one in five infections are resistant to commonly used antibiotics.
That statistic should alarm us. But …
Antimicrobial resistance causes: Why social factors matter more than drugs
Every night I spend at home, I wake up to the sound of Für Elise by Ludwig van Beethoven. If you asked my dad, who works remotely, he would grimace and tell you he hears it at least 10 times a day. It’s a classic piano piece, don’t get me wrong, but we don’t have a piano, nor are we a family of Beethoven fanatics. My dad probably loved Beethoven …
Immigrant caregiver burden: the hidden cost of the five-year Medicaid wait
Today’s clinicians are spending more time documenting care than delivering it. This reality is not lost on health care providers, many of whom feel burnt out and unfulfilled by this overwhelming administrative burden. The digitization of health care, which once felt like a promise of efficiency, has pulled clinicians away from patients and toward screens. The problem isn’t technology itself; it’s the result of poorly designed siloed solutions and disconnected …
Connected health care workflows: From chore to core patient care
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Family physician Kelly Bain discusses her article “Why physician business literacy matters.” Kelly explains that while doctors are trained to diagnose and treat patients, they are rarely prepared to navigate the complex …
Business literacy empowers physicians to lead sustainable health systems [PODCAST]
We are born into corridors,
measured, labeled,
painted neutral,
walls rising before we learn how wide
our thoughts can stretch.
Lines are drawn early:
This is far enough,
this is acceptable,
this is where you stop.
We are told our ideas must sit quietly,
folded into boxes like unused maps,
that imagination is dangerous if it wanders,
that questions should behave
and answers should already be known.
Life, they say, is safest when it stays
inside the margins.
But something restless stirs
beneath the rules.
A pulse.
A whisper …
The necessity of getting lost to find yourself
Medicine has always loved the story of the hero.
The physician who pushes through exhaustion. The one who catches the rare diagnosis at the last second. The colleague who seems to carry an impossible load without ever dropping the ball.
But after years of watching which physicians actually thrive, not just survive, I have come to believe we have been telling the wrong story.
The doctors who perform at the highest level over …
Physician resilience: Why systems matter more than heroism
My wife underwent major surgery in December 2025. She remained 10 days in a Charlotte, NC, hospital and was then for several weeks supported at home by visiting nurses, a physical therapist, and a dietician. We just saw the bill: The hospital and participating doctors submitted bills of $120,000 to Medicare and to Tricare (family health insurance for military service veterans like me).
The 21 years that I served as a …
Medical bankruptcy: the hidden cost of U.S. health care
If a new disease emerged and killed this many people, everyone would be talking about it. This death rate has been constant over the last decade, despite the declining prevalence of cigarette smoking. The decline in prevalence is, for the most part, due to reduced adoption of smoking by teenagers, and younger smokers have been shifting to vaping. The prevalence of smoking among older, poor, less well-educated, and rural populations …
Tobacco treatment neglect: Why 25 million smokers are left behind
Hot off the presses. The latest science proves, yet again, that music benefits your brain, and not in some vague, feel-good way; it physically remodels your brain in ways that make you calmer, sharper, and happier. I’m talking about measurable rewiring, anxiety reduction, and cognitive gains you can actually see on an fMRI.
Three rock-solid studies just landed:
1. Chinese researchers and anxiety reduction
Chinese researchers took a bunch of stressed-out college students …
Music and brain plasticity: How sound rewires your mind
More than a month after HSA-eligible direct primary care became available, independent practices remain unprepared for the operational complexity employer contracts require. The DPC community celebrated regulatory victory. Private equity prepared infrastructure.
That preparation became visible throughout 2025. Frontier Direct Care announced a $20 million Series B to expand its employer-sponsored DPC platform. Marathon Health, formed from the 2024 Everside merger, operates …
Employer-sponsored DPC: Why private equity is winning the infrastructure race
Before complex medical interventions ever reach patients, their effectiveness must be scientifically proven through rigorous testing in controlled settings such as laboratories and research facilities. But ensuring effectiveness doesn’t stop there. The process of assessing a medical treatment’s usefulness is multilayered and requires investigation that goes well beyond the laboratory. It must also assess how the treatment fares in day-to-day clinical practice for a wide variety of patients. Now, as …
Validating AI in health care: the role of real-world evidence
Evelyn felt fine that morning. At 68, she was active, healthy, and just returned from her daily walk when her heart began to flutter. It wasn’t painful, just an odd sensation, like a fish flopping in her chest. It lasted around 10 minutes and then stopped. Although she thought it was strange, she soon dismissed it. A week later, she woke up unable to move her right side. A stroke …
Why Medicare must cover atrial fibrillation screening to prevent strokes
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Psychiatrist Sarah Hollander, clinical psychologist Kelly D. Holder, and physician advocate and physical therapist Kim Downey discuss their article “Joy in medicine: a new culture.” Sarah, Kelly, and Kim explore how the …
Teaching joy transforms the future of medical practice [PODCAST]
I was always taught to show respect to older relatives through the mano po gesture. If I were meeting a new family member, I would say “Ang pangalan ko Joaquim” to introduce myself. However, since immigrating to the United States from the Philippines, there are fewer and fewer people who call me by my actual name.
My family immigrated to the United States in 2002 after my mother accepted an opportunity …
Why Filipino nurses faced higher COVID-19 mortality rates
As clinicians, we are trained to look for disease.
We measure blood pressure, blood sugar, lung function, and imaging results, often waiting for pathology to declare itself before we intervene. During the COVID-19 pandemic, however, many of us noticed something unsettling: patients were not only arriving later, they were arriving weaker.
Recent evidence confirms this clinical intuition. An analysis published in The BMJ, examining health records from more than 30 million people, …
Frailty and functional decline: Why diagnosis is not enough
Egregious ethical failures in health care almost always gain attention. Less visible, but no less consequential, are the systemic ones that are often overlooked: routine acts that present themselves as morally neutral, procedural, and unremarkable. They usually do not provoke outrage and are not experienced as trauma. Yet over time, one must be concerned about how they quietly reshape our well-being and our professional identities.
The effect of these acts does …
Moral injury in medicine: When silence becomes a survival strategy
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