He literally rolls into my office every three months, shoes still clipped to his carbon-fiber lifestyle. Lycra damp, Apple Watch buzzing, resting heart rate of 42. He is fit, smart, and tightly wound.
“Doc,” he begins, eyes wide, “I read that morning workouts burn more fat and lower clotting factors. Should I move my rides earlier? Or maybe late evening is better for heart rate variability?”
This is a man who, when …
This article is sponsored by Takeda.
When I started in gastroenterology 19 years ago, I didn’t imagine my professional journey would lead me to specialize so deeply in inflammatory bowel disease (IBD). But once I began caring for people with Crohn’s disease and …
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Internal medicine-pediatric physician Chrissie Ott discusses her article “When the pediatrician is the parent: a personal reckoning with childhood obesity.” Chrissie shares the deeply personal story of her own child’s struggles with …
A young woman in her late twenties came to me after surgery for extensive endometriosis. The procedure had given her relief; her pain was gone. Her follow-up testing looked reassuring: her fallopian tubes were open on hysterosalpingogram (HSG), and her anti-Müllerian hormone (AMH) level was above 4 ng/mL, which is considered normal. Her question was straightforward: “If my AMH is good and my tubes are open, doesn’t that mean everything …
My current feeling as a nurse is more closely related to those of a line cook than to what I imagined nursing would be. Patients arrive with complex medical needs, yet we are forced to see them as checklists to be processed before the next shift arrives. Turnover feels like moving products down a line instead of treating people with care and dignity. This is not a failure of individual …
Commercial airline pilots are required to retire at 65 under Federal Aviation Administration regulations. It’s not ageism; it’s safety. Yet physicians, whose decisions can be just as life-or-death, face no such requirement. As a former internist, chief medical officer, and hospital CEO, I have seen what happens when physicians practice past their prime. The results can be dangerous, heartbreaking, and entirely preventable.
When “going out on top” doesn’t happen
During my tenure …
An excerpt from Born to Heal: Medical Narratives Set to the Soundtrack of Classic Rock.
Dr. Raul Morales sat alone in Exam Room 3, now used for storage, staring out at the fading autumn light through a slit in the blinds. The clinic was quiet, eerily so. His last patient had left an hour ago. He was supposed to be packing up his …
Sarah, an emergency room nurse with eight years of experience, did not leave because she stopped caring. She left because the numbers no longer worked. Student loans outpaced her wages, overtime became mandatory without premium pay, and patient loads rose to unsafe levels. Eventually, the arithmetic of her life and work collapsed.
Sarah’s story is not unusual. Across the country, clinicians are leaving medicine in numbers that no longer feel like …
Each academic year, I have watched as a new class of residents and fellows prepares to graduate and launch their medical careers. They step out of the structured training environment into a professional world that is exciting, expansive, and, for many, overwhelming. Clinically, they are well trained. But residency rarely prepares physicians to recognize and advocate for what they truly need to thrive in practice. The data reflect this gap. …
An excerpt from Whispers of the Mind: A Neurologist’s Memoir.
I have never been one to seek out medical care, as I have been fortunate to have been in excellent health most of my life. So, when I presented to my GYN for my yearly follow-up, I brought up my first health complaint in the twenty years I had been seeing her, abnormal bleeding. We were colleagues and she knew …
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Physician-scientist Diego R. Hijano discusses his article “How humor builds trust in pediatric oncology.” Diego shares how personal loss and his own cultural and linguistic experiences shaped his approach to care, teaching …
We all know the look of a patient about to crash. The monitor has not flatlined yet, but the story is already in the vitals: The pulse is racing, the pressure is dropping, the skin is clammy.
That is the U.S. economy right now. Debt overload looks like a chronic hemorrhage. High interest rates are a sustained hypertensive crisis. Political paralysis is the family arguing in the hallway while the patient …
Physicians who are also business owners have two jobs: treating patients and running their business. Hiring and keeping employees is one of the job descriptions of the latter. It is no surprise that choosing and maintaining employee benefits is not at the top of an exciting to-do list. Even if hospital systems are not your direct competition, they are often competing for …
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An excerpt from The Parkinson’s Plan: A New Path to Prevention and Treatment.
The Parkinson’s universe
In 2002, we proposed a simple Parkinson’s care model. The patient is the sun, and all multidisciplinary care should orbit around the patient, not the doctors. The sun is vital but only part of the universe. It is time to expand our Parkinson’s care model.
The caregivers
If we …
An excerpt from Scary Diagnosis: Navigating Fear, Finding Strength, and Securing the Health Care You Deserve.
Doctors are the centerpiece of the health care system. In large part, they have designed it, written its rules, lobbied the government to support it financially, and, through doctor-friendly regulation, they are its main financial beneficiaries. For most patients, their doctor is not just the centerpiece of a huge system; they represent the entire …
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Primary care physician Jerina Gani discusses her article “My journey to loving primary care again.” Jerina shares her deeply personal story of nearly walking away from medicine after burnout, exhaustion, and endless …
Introduction: a double-edged disruptor
Artificial intelligence (AI) has quickly insinuated itself and is transforming nearly every corner of modern life. Health care is no exception. With the rise of advanced chatbots, symptom checkers, and health-focused algorithms, patients now have 24/7 access to vast medical knowledge at their fingertips in seconds. The excitement is understandable: AI can demystify medical “doctor-speak” or jargon, suggest possible diagnoses and treatment options, and empower patients to …
On October 7, 2023, more than 1,200 people were murdered in a single day in the Hamas-led terror attacks in southern Israel, and over 250 individuals were taken hostage. This was the deadliest antisemitic attack since the Holocaust. For many Jewish health care workers, it marked a devastating shift: Our hospitals and clinics were no longer safe, not because of external conflict, but simply because we are Jewish. We had …
I love technology. I love the health care AI I use every week including Viz.ai and OpenEvidence and Glass Health. I am generally a tech optimist. And even as cries of overhype on artificial intelligence start wading into the public discourse, I truly believe that AI will as fundamentally alter society and health care as the internet or the mobile phone.
But, I am convinced the whole industry is doing AI …
People living with inherited bleeding disorders (including those with mild and moderate hemophilia and females affected by hemophilia) face persistent unmet needs that are often overlooked in clinical research and treatment guidelines. About twenty percent of mild hemophilia cases experience serious bleeding episodes, challenging current assumptions of their benign course.
Unmet needs
Diagnosis and awareness: Patients with mild and moderate hemophilia often face a delayed or missed diagnosis, leading to unrecognized and …
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