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
Artificial intelligence (AI) is the biggest economic craze since cryptocurrencies, and GLP-1 agonists are the biggest health craze since statins. But are they as good for users as producers and Wall Street? Will they implode like their predecessors?
We spoke with behavior change expert Kyra Bobinet, MD, author of Unstoppable Brain: The New Neuroscience That Frees Us From Failure, Eases Our Stress, and Creates Lasting Change. She maintains that both …
Iterative mindset versus AI and GLP-1s: Why shortcuts weaken the brain
Autism is typically framed as a neurodevelopmental condition defined by differences in social communication, sensory processing, and behavior. This framing is incomplete. In clinical practice, autistic individuals frequently present with a striking burden of systemic symptoms involving the gastrointestinal tract, cardiovascular regulation, immune signaling, connective tissue, and stress physiology. These are not side notes. They reflect the fact that autism lives within a nervous system that innervates the entire body.
The …
Autism comorbidities: the hidden link between POTS, GI issues, and hypermobility
For most of my life, preventable infectious diseases existed at the margins of medicine. Influenza was seasonal but manageable. Hepatitis outbreaks were contained. Childhood hospitalizations from rotavirus or meningococcal disease were rare enough to be notable. COVID-19 may have shattered predictability, but even then, many of us believed the lessons we learned would be followed by renewed investment in prevention.
Instead, we now stand at a crossroads.
A crossroads in prevention
Recent guideline …
The impact of CDC’s new childhood immunization guidance
For most of my nursing career, my instinct when work felt overwhelming was always the same: Look inward, fix myself, and try harder.
If a shift felt chaotic, I assumed I needed to manage my time better. If an interaction went poorly, I replayed it in my mind, wondering what I could have said differently. If I came home exhausted and irritable, I told myself I needed thicker skin. I believed …
Remote nursing for burnout: How changing environments saved my career
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Board-certified pediatrician, certified coach, and mindfulness and yoga teacher Jessie Mahoney discusses her article “Pediatrician vs. grandmother: Choosing love over medical advice.” Jessie explores the internal conflict she faced between her medical …
Doctors often struggle to separate professional advice from family love [PODCAST]
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