During the COVID-19 pandemic, while some people learned to bake bread and my family made the dubious choice of adopting a high-anxiety poodle who bites, superstar author Lisa See spotted an unopened book on her shelf about women’s medicine in Imperial China. In a fortuitous chain of discovery, Ms. See stumbled upon the name of Tan Yuxiang, a lady doctor during the Ming Dynasty, who published a book of her …
Difficult patients in medical history
Hospitals are not the only ones who rely on volunteers.
Nonprofits rely on them for aging programs. Faith communities rely on them for spiritual formation. Philanthropy relies on them for legitimacy. Even emerging “wellness” and “compassion training” industries rely on them for content and credibility.
But no one ever asks: Who sustains the sustainers?
For more than 20 years, I have watched hospital volunteers become the invisible infrastructure of modern care. We are …
The emotional labor of volunteering in an aging society
As a family medicine resident physician who practices primary care, it is my responsibility to be the first doctor a patient, their family, and their community may visit for any undifferentiated issue. No other field of medicine increases the life expectancy and the quality of life in a community as much as primary care, which provides more meaning to me than can be qualified. My objective is for people to …
Understanding the evolutionary mismatch in health and modern disease
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Obstetrician-gynecologist Priya Panneerselvam discusses their article “How medicine reflects women’s silence.” Priya discusses how the quiet deference observed in their mother’s generation continues to manifest in patients who apologize for their pain …
Silence is a survival mechanism that costs women their joy [PODCAST]
On January 6, 2026, the FDA announced revised guidance that loosens oversight for certain AI-enabled digital health products, most notably clinical decision support (CDS) software. The goal was to cut unnecessary regulation and promote innovation, accelerating time-to-market for tools positioned as clinical assistants rather than autonomous decision-makers.
At first glance, the change looks pragmatic, even overdue. For years, developers and clinicians alike have complained that prior FDA interpretations forced artificial …
FDA loosens AI oversight: What clinicians need to know about the 2026 guidance
United States (U.S.) health care, once a citadel of innovation and quality, has sadly devolved into a complex, frustrating, and frequently inaccessible system. It is so disorganized and inefficient it might not even meet the definition of a “system.” U.S. health care fails to address the needs and expectations of patients on many occasions and in many ways. For most of my career, I have considered U.S. health care the …
Why the U.S. health care system is failing patients and physicians
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Health care executive Dave Wessinger discusses their article “How to adopt AI in health care responsibly.” Dave explains why organizations must move beyond the hype of artificial intelligence to focus on measurable …
Focusing on outcomes over novelty prevents AI failure in health care [PODCAST]
“Oh, good, there’s our diversity in the slideshow!” said my supervisor. I was a college student leading a mentorship program for community youth at my predominantly white university, and I was one of two students of color on the leadership team. We were putting together a grant presentation, and in our slide deck there was a slide entitled “Diversity, Equity, and Inclusion,” which addressed in detail the program’s awareness of …
What is the minority tax in medicine?
As major public health agencies such as the Centers for Disease Control and Prevention (CDC), the Department of Health and Human Services (HHS), and state health departments face reductions in scope and resources, a unique opportunity arises for health insurers to take a leading role in improving public health, while also enhancing their own reputations and financial sustainability.
Consider tobacco use, the leading cause of preventable death in the United States, …
Putting health back into insurance: the case for tobacco cessation
When I began my surgical training in the 1990s, vascular surgery looked very different than what it does today. At that time, only a small number of physicians specialized in treating blood vessel diseases, and even fewer practiced in Brooklyn. I chose to complete my education and surgical training here in New York so I could stay rooted in the community I care most about. As the second board-certified vascular …
Why Brooklyn’s aging population needs more vascular health specialists
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Urologist Tracy Gapin discusses their article “Is your medical career a golden cage?” Tracy explores the paradox of achieving professional success while feeling trapped in a demoralizing and insurance-driven health care system. …
Escaping the golden cage of traditional medical practice to find joy again [PODCAST]
When asked what I wanted to be when I grew up, the answer changed from ballerina to teacher to everything in between. One thing remained constant: I wanted to be a mother. I have narrowed my career aspirations to becoming a physician, but my desire to be a mom has been unwavering. In a climate where maternal mental health is so misunderstood, I constantly wonder what support I will have …
Why pediatricians are key to postpartum depression screening
I’ve spent my entire professional life practicing medicine, guiding patients through uncertainty, and translating complex science into actionable information that could be clearly understood. I thought I had a solid grasp on what it meant to face illness. I thought I knew how to navigate the medical maze and interpret all the jargon.
Nothing prepared me for the moment when I became a patient.
The diagnosis was prostate cancer.
Suddenly, I wasn’t the …
Prostate cancer genomic testing: a physician-patient’s perspective
In the first episode of The Pitt season 2, Dr. Robby reveals he’s taking a three-month sabbatical, his last shift before heading to a UNESCO World Heritage Site in Canada. For a primetime medical drama to feature a physician stepping away for three months signals something important: Sabbaticals are entering the cultural conversation about how doctors survive in modern medicine.
But here’s what the show doesn’t tell you: Most physicians can’t …
Why every physician needs a sabbatical (and how to take one)
Recent federal policy discussions have introduced a framework that would place health care affordability dollars into individual-controlled accounts rather than routing them through insurers or employer benefit plans. Still at the framework stage and requiring legislative action, the architecture being explored signals a potential shift in how health care purchasing power flows through the system.
Whether or not this specific framework advances, the direction of travel is clear. Health care …
Retail health care vs. employer DPC: Preparing for 2026 policy shifts
In Taiwan, the year 2026 marks our transition into a “super-aged society,” where more than 20 percent of the population is over 65. Yet what strikes me most is not the demographic milestone itself, but what it does to the dinner table.
During Lunar New Year gatherings, I often observe a tense choreography among middle-aged children. Who will take father to his cardiology appointment? Who will accompany mother during the day? …
Taiwan’s “Yi-Dong-Yang”: a preventive aging model for super-aged societies
The first denial arrived not with cruelty or malice, but with a phrase so familiar it barely registers as language anymore: “not medically necessary.” The cancer drug, recommended by oncologists and supported by evidence and standard of care, was rejected. No phone call. No physician-to-physician conversation. Just an automated letter and a bureaucratic pause inserted into a life that no longer had room for delay.
The family appealed. They fought. They …
The moral injury of “not medically necessary” denials
After years of leading palliative medicine departments, as a Fellow of the American Academy of Hospice and Palliative Medicine, I’ve had countless conversations that start the same way. A colleague in the hallway says, “Oh, palliative care—that’s so important. You all are so nice.” Or a hospital administrator tells me, “We wish we could give you more, but resources are tight right now.” Or my personal favorite: “Palliative care is …
What is palliative medicine and why is it so misunderstood?
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Kenneth Botelho, founding director of the doctor of medical science (DMSc) program at The College of St. Scholastica and a physician assistant, discusses his article “Federal graduate-loan caps threaten rural health care …
Capping student loans destroys the rural medical pipeline [PODCAST]
Can there actually be a medical profession with physicians as only employees in an industrialized corporate or socialized system with a union representing their collective interests? Does it matter, and should it matter? Are there still alternatives?
Asking another party, specifically the government, to solve major predicaments consuming the profession is not a plan. Worse, it is a clear sign of dependency and weakness. There is no other entity that can …
Is physician unionization the answer to a broken health care system?
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