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Setting boundaries as a physician doesn’t mean caring less

Jerina Gani, MD, MPH

September 21, 2026Sep 21, 2026

For years, I thought good doctors always said yes. Can you squeeze in one more patient? Yes. Can you answer this message before you leave? Of course. Can you finish this chart tonight? Yes. Can you take care of just…

For years, I thought good doctors always said yes.

Can you squeeze in one more patient? Yes. Can you answer this message before you leave? Of course. Can you finish this chart tonight? Yes. Can you take care of just one more thing? Absolutely.

It rarely felt like a major decision. Each request seemed small. A few more minutes. One more patient. One more message. But small yeses have a way of …

Short bursts of exercise can ease the afternoon slump

Neil Baum, MD

September 21, 2026Sep 21, 2026

A solution to the typical afternoon sinking spell is short bursts of exercise. In this blog, I will discuss the concept of short bursts of exercise and how just 1 to 2 minutes of cardio exercise that won't make you…

The evidence continues to grow that even short periods of activity can make a difference. A recent …

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Pediatric euthanasia and the fear of a new eugenics

Arthur Lazarus, MD, MBA

September 21, 2026Sep 21, 2026

Adapted from The New Eugenics in Medicine: Two Novellas About Power, Science, and the Future of Human Worth. The Netherlands' first reported termination of life in a child between ages 1 and 12 under its 2024 framework for regulating pediatric…

Adapted from The New Eugenics in Medicine: Two Novellas About Power, Science, and the Future of Human Worth.

The Netherlands’ first reported termination of life in a child between ages 1 and 12 under its 2024 framework for regulating pediatric euthanasia has become a global lightning rod for debate over the merits and sins of euthanasia.

A Dutch child was almost 2 years old and had been born at 26 …

Retirement isn’t the end of medicine, it’s a second act [PODCAST]

September 20, 2026Sep 20, 20262

Many doctors picture themselves practicing until the day they die. Andrea Hayes decided otherwise, and tells you what came next. She is a retired endocrinologist, author, and speaker. This episode is based on her article "From endocrinologist to writer: a…

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Drugs and prescribing

Why cannabis use disorder and withdrawal go unnoticed

Ginger Constantine, MD

September 20, 2026Sep 20, 2026

Cannabis use disorder (CUD) and cannabis withdrawal syndrome (CWS) have been recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for more than a decade. Researchers have documented symptoms of anxiety, irritability, insomnia, depression, decreased appetite, intense cravings, physical symptoms, and more. Despite years of published evidence, cannabis use disorder remains one of the most underrecognized and under-resourced substance use disorders in health care. The latest findings from …

Medical education

What clinical support staff notice that charts never show

Maria Alemu

September 20, 2026Sep 20, 2026

As I draped the ultrasound table and laid out the sterile speculum, I noticed my patient's shoulders were locked near her ears. Her chart noted a history of failed fertility cycles, but her vitals on the intake sheet were perfectly…

As I draped the ultrasound table and laid out the sterile speculum, I noticed my patient’s shoulders were locked near her ears. Her chart noted a history of failed fertility cycles, but her vitals on the intake sheet were perfectly normal.

It would have been easy to finish setting up the tray, check the box, and fetch the physician. Instead, I paused and asked, “How are you holding up today?”

She exhaled …

How to diagnose supplement toxicity in 4 clinical steps

Alisa Sano, MPH

September 20, 2026Sep 20, 2026

Only 33 percent of patients who use herbs or supplements disclose their use to health care providers, often viewing them as natural and therefore harmless. Targeted history-taking is the ultimate line of defense for ruling in or out herbal/dietary supplement-induced…

Clinicians must look beyond standard prescription lists and systematically audit everything a patient ingests. Asking a few high-yield questions …

Chronic inflammation and immune aging may share mechanisms

Andrew Caravello, DO

September 20, 2026Sep 20, 2026

For more than two decades, I have practiced emergency medicine. The job trains you to recognize patterns quickly because sometimes the pattern is the difference between sending someone home and recognizing a catastrophe that is still assembling itself. A heart…

A heart attack arrives after years of vascular disease and suddenly becomes an emergency. A stroke may represent decades of biology revealed in minutes. Sepsis can turn a functioning immune system into something …

Family history of PCOS can reshape metabolic care

Jan Hinnen, MD

September 20, 2026Sep 20, 2026

A 30-year-old man with obesity and longstanding type 2 diabetes comes in for a routine follow-up. His glycemic control remains poor despite treatment. As the visit unfolds, his physician notices persistent adult-onset acne. Years ago, the encounter might have ended there. Today, I imagine asking another question: “Does anyone in your family have what we used to call polycystic ovary syndrome?” His sister does.

That answer does not diagnose him with …

Geoffrey Mount Varner, MD, MPH

How emergency medicine decision making works under pressure

September 20, 2026Sep 20, 2026

Ask most physicians outside emergency medicine how they'd handle a patient presenting with three possible diagnoses, incomplete labs, and a deteriorating vital sign trend, and you'll usually get a version of "I'd want more information first." Ask an ER physician…

Ask most physicians outside emergency medicine how they’d handle a patient presenting with three possible diagnoses, incomplete labs, and a deteriorating vital sign trend, and you’ll usually get a version of “I’d want more information first.” Ask an ER physician the same question, and you’ll get an action plan within seconds. That gap isn’t intelligence. It’s training. And I think it’s worth naming exactly what that training builds, because most …

Blaming the doctor is cheaper than fixing the record system [PODCAST]

September 19, 2026Sep 19, 2026

A pediatrician gave a child vaccines the chart said he needed. The record showing he had already had them was buried in the system. Dennis Hursh is a health law attorney and founder of Physician Agreements Health Law. This episode…

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Medical education

Learning empathy in medical school took my father’s cancer

Sneha Dabadi

September 19, 2026Sep 19, 2026

It was the month of February; there was a different excitement and joy in my family as we were planning my little brother's Bratabanda. It was special not only because we had a special occasion but also because it was…

It was the month of February; there was a different excitement and joy in my family as we were planning my little brother’s Bratabanda. It was special not only because we had a special occasion but also because it was the very first function organized by my family. On the Bratabanda day, we were all very busy, and the party was about to end; my father’s school friend group joined. …

Why I stay in emergency medicine: a dancer at nearly 100

Howie Mell, MD, MPH

September 19, 2026Sep 19, 2026

People ask what being an emergency physician is like, and they expect the blood, the saves, the codes, the worst nights. Those happen, and they matter, but I try not to carry those home. What I try to keep is…

What being cleared for surgery does not actually mean

Dr. Girishkumar Modi

September 19, 2026Sep 19, 2026

A patient arrives for surgery after weeks of waiting. They have fasted, taken time off work, arranged transport, and prepared themselves mentally for the operation. Then the anesthesiologist says, "I think we should wait." For the patient, this can be…

For the patient, this can be frustrating. “I feel fine.” “Why can’t we just go ahead?” These are understandable questions. But one of the less visible parts of an anesthesiologist’s job is deciding not only how to …

Distrust of science is inviting the Middle Ages back

Tomi Mitchell, MD

September 19, 2026Sep 19, 2026

A few days ago, I saw a fake book cover online that was so ridiculous I laughed out loud. It was beautifully designed: deep red. Ornate gold lettering. The kind of cover that looks as though it belongs in a medieval monastery, chained to a wooden desk while a monk copies its contents by candlelight.

The title? How to Avoid Vaccines & Die Like a Medieval Peasant. The author? Robert F. …

How CREST-2 changes asymptomatic carotid stenosis treatment

John R. Laird, Jr., MD

September 19, 2026Sep 19, 2026

Carotid artery disease remains a major contributor to ischemic stroke, one of the leading causes of death and long-term disability in the United States. While symptomatic carotid stenosis has well-established treatment pathways, the management of asymptomatic carotid artery disease remains an area of ongoing debate. Traditional treatment methods such as intensive medical management have largely functioned as the standard of care for asymptomatic carotid artery disease, with revascularization (carotid endarterectomy …

Physician reimbursement cuts collide with AI audits

Kayvan Haddadan, MD

September 19, 2026Sep 19, 2026

Physician reimbursement has faced sustained downward pressure for years, while insurers have expanded tools, including AI-driven audits, prior authorizations, and retrospective reviews, so that they can recover or limit payments after (or before) services are delivered. This dynamic contributes to practice strain, consolidation, and reduced patient access. Evidence from Medicare data, physician surveys, and industry analyses supports the core concerns. Not every claim of intentional misconduct or pure profit …

Patient voices

Patient communication ends when the patient understands

Diane Bruno

September 19, 2026Sep 19, 2026

For decades, we have been told the stories of medicine through the eyes of the people who provide it. Medical dramas place doctors and nurses at the center of the narrative: the brilliant surgeon making impossible decisions, the exhausted emergency physician racing against time, the nurse carrying the emotional weight of caring for patients through crisis. Even in today’s most authentic medical dramas, including The Pitt, patients are often catalysts …