As physicians, we’re used to thinking about dose (how much medication, how often, and for how long). But there’s another dimension that’s often overlooked: time. For decades, we’ve known that the body processes medicines differently depending on the time of day. A blood pressure pill or chemotherapy drug can have markedly different effects depending on when it’s taken. This field, known as chronopharmacology, has transformed how we think about drug …
Larry is a friend. We are not besties. He is a neighbor, a few miles down the road from our forty-eight-acre hobby farm in our quaint little town, surrounded by farmland, generational farmers, rusted old tractors, cornfields, livestock, and a few homes interspersed in between. He is a neighbor, nonetheless. And a friend.
I first met Larry when we were building our country home, where my wife dreamt of raising a …
I am a cancer doctor.
It took me many years to become one and while I paid for my medical school tuition, my residency and fellowship training was partially subsidized by government funds for general medical education. Every residency and fellowship is partially funded this way because the government recognizes the need for doctors. I have also had an NIH funded basic research lab where I did research that has contributed …
California Governor Gavin Newsom recently made headlines for his marathon public appearances, speeches, and press briefings. Watching him, I could not help but wonder what his voice coach or speech-language pathologist might say. As a clinician who specializes in voice therapy, I see teachers, pastors, lawyers, and health care providers (people who depend on their voices every day). Politicians are no different.
Our voices are often our most valuable tool, yet …
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Rheumatologist Ananta Subedi discusses his article “The 4 foundations that sustain physicians through burnout and balance.” Ananta reflects on his journey from medical education in Nepal to building a rheumatology practice in …
For decades, neurology has told us that Alzheimer’s disease is caused by toxic proteins (amyloid plaques and tau tangles) that clog the brain. Pharmaceutical companies have poured billions into anti-amyloid drugs designed to wash them away. The results? Repeated failures, high-profile disappointments, and a handful of marginal approvals with no meaningful improvement in patients’ lives. Sound familiar? In cardiology, we’ve built an entire industry on lowering LDL cholesterol. Statins move …
It should come as no surprise that GLP-1 receptor agonists have revolutionized the management of obesity and metabolic syndrome. These drugs have shown extraordinary promise in regulating appetite, promoting weight loss, and improving blood sugar control. Nearly one in eight adults (twelve percent) have taken a GLP-1 agonist, and forty-three percent of adults diagnosed with diabetes have used these therapies, numbers likely to have increased further in the last year …
Physician burnout and physician suicide continue to plague the medical profession. Everyone knows the tragic statistic: one U.S. physician commits suicide each day. While some statistics report a decrease in the problem over time, the accuracy of these reports is questionable. The reality is that it is far too common.
The term burnout, while a necessary label, implies that a single factor causes it. In reality, each burned-out physician is different. …
What if recovery from depression was not only about reducing symptoms, but about rekindling a person’s inner spark?
During my years as a Navy nurse in mental health, I witnessed countless people navigating the heavy fog of depression. Many were offered medication, therapy, or structured activity schedules. These approaches saved lives and improved outcomes. Yet sometimes, despite best efforts, patients still felt like they were going through the motions, managing symptoms …
The interview ends. The line goes dead. A senior CDC official has resigned, not because the science changed, but because the room did. Within forty-eight hours, CDC Director Monarez is fired by tweet, three senior leaders walk out, and a deputy from HHS (Jim O’Neill, a Silicon Valley investor turned political enforcer) is slotted in as acting CDC chief.
The headlines say turmoil. That is the polite word for capture.
Meanwhile, the …
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Nurse practitioner Elisabeth Evans discusses her article “The critical role of nurse practitioners in colorectal cancer screening.” Elisabeth shares why colorectal cancer is the second-deadliest cancer in the U.S. yet remains under-screened, …
In the world of global surgery, progress is a word we love to repeat. Since 2015, we have celebrated the drafting of National Surgical, Obstetric, and Anaesthesia Plans (NSOAPs), applauded World Health Assembly resolutions, and cited countless academic papers. But walk into a district hospital in a low- or middle-income country, and the patient waiting for a life-saving operation will not feel that progress. For them, the promises of global …
Every week, I see patients not because they need to, but because their insurance company says they must. A patient came in recently for one reason only: Her insurer required a referral before she could see a specialist. She didn’t want to. I didn’t need her to. But we both had no choice. After a 20-minute visit neither of us needed, I did what the insurer required: document, click, submit. …
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The patient was in her forties. She experienced chest pain, but it did not appear to be “classic.” Her ECG was normal. Her labs did not raise alarms. The team leaned toward anxiety. Hours later, she went into cardiac arrest from a heart attack. That silence after the code still stays with me. We anchored on the first test. We closed the case too early. We stopped listening to her …
Money management and career planning are considered life skills (but the skill that shapes health self-advocacy) deserves the same status. Without it, care suffers. My family member was recovering from surgery, facing medication safety concerns, severe anxiety, and the need for constant care. At the same time, I was managing my own records and preventive health. Like so many women, I had become the family’s chief health executive, carrying responsibilities …
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Internal medicine physician Sally Daganzo discusses her article “How functional medicine fills the gaps left by conventional care.” Sally explains how a systems-based, evidence-informed approach can uncover root causes of complex conditions …
At the recent ECTRIMS Congress in Barcelona, researchers presented data that should make every specialist pause. In a claims analysis of nearly 70,000 patients with multiple sclerosis (MS), 98 percent of infections were first detected not in neurology clinics, but in primary care and other non-neurology practices. Even “serious” infections requiring hospitalization were almost entirely picked up elsewhere. The message was clear: Specialists, by design, often miss the forest for …
“Do you know what it feels like, to know you could die at any moment?” His words linger in the air, heavy, long after the threat of violence has passed, long after our team has calmed him with words and soft gestures. It is not the first time a patient’s family member has swung at me, nor will it be the last. But it is the first time with a …
There’s a common belief that leadership requires a title after your name, an office on the top floor, and people looking to you for direction. But in medicine, leadership happens at every level.
Take me, for example. I’m an attending physician, whose role on the team is as a hospitalist. In the hierarchy of medicine, it’s easy to dismiss this role as “just a physician.”
Yet there’s nothing “just” about it when …
The pilgrimage of my dreams included a suitcase full of diapers, extra pants, and a quiet prayer for dignity. Italy has always been a dream destination for me. As a Catholic, I consider Rome the Holy City of my faith, and this year’s Jubilee motivated me to visit the four Holy Doors. I also love art and culture, and Italy is home to many historic sites and great works of …
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