Rethinking cholesterol and atherosclerosis

Conditions
October 27, 2025

A recent Washington Post article called for earlier detection of atherosclerosis and a shift from “ischemia-centric” thinking to an “atheroma-centric” model. That’s progress, but it’s still missing the most important piece: Plaque isn’t the root cause.

For 50 years, we’ve built a trillion-dollar cardiology machine around the cholesterol hypothesis. Statins, PCSK9 inhibitors, ezetimibe, inclisiran, Lp(a) drugs, all circling the same biochemical drain. LDL plays a role, yes. But LDL is …

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Why doctors need emotional skills to survive

Conditions
October 27, 2025

HBO’s The Pitt collected thirteen Primetime Emmy nominations this year, winning both Outstanding Drama Series and Outstanding Lead Actor in a Drama Series for Noah Wyle. But the recognition was not just for great television. The series struck a cultural nerve because it captured something raw and real: the emotional side of medicine. Viewers saw the chaos of an emergency room after a mass casualty event, the head physician …

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Stepping down in medicine: Why letting go can be an act of leadership [PODCAST]

Podcast
October 26, 2025
YouTube video

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Physician and coach Jessie Mahoney discusses her article “Stepping down in medicine is an evolution.” In this episode, Jessie challenges the cultural belief that stepping down from medical roles is a sign …

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The debate on English tests for immigrant nurses

Conditions
October 26, 2025

As a research scientist who is devoted to ensuring that immigrant nurses have successful U.S. careers, the issue of internationally educated nurses’ (IENs’) cross-culture language competence has recently been both a sensitive and front-and-center issue pervading my work. In my more than 30 years in the health care sphere, the topic is now reaching a fever-pitch as IENs increasingly enter the U.S. health care workforce and play a critical role …

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The FQHC model and medicine’s moral promise

Physician
October 26, 2025

The Federally Qualified Health Center stands as perhaps the most eloquent institutional response to the perennial tension between medicine as market commodity and medicine as moral imperative. In the concrete reality of the FQHC (with its sliding-fee scales, its community governance structures, and its legislative mandate to serve the underserved) we find materialized those aspirations that have animated medical ethics since the Hippocratic tradition: that healing should flow toward need …

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AI companions and loneliness

Tech
October 26, 2025

Into this psychological wasteland, we’re now introducing AI companions as the solution. Meta’s personas, Character.AI’s virtual friends, and romantic chatbots; the market for artificial intimacy is exploding. The promise is seductive: connection without risk, companionship without effort, and validation on demand.

But here’s what these AI relationships actually do: They allow users to avoid the very challenges that build psychological resilience. Genuine relationships require vulnerability, the ability to tolerate conflict, and …

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The frustrating bureaucracy of getting a vaccine

Conditions
October 26, 2025

At age 81, I speak and write voluminously as a health care educator specializing in public health policy and practice for the treatment of pain and addiction. My wife and I are also careful about getting our periodic vaccinations for flu and COVID-19. A few days ago we responded to an invitation from our pharmacy to drop in for our shots on a walk-in basis. The process turned out to …

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Who profits from medical malpractice lawsuits?

Physician
October 26, 2025

I define a frivolous medical malpractice lawsuit as being caused by a random error of nature.

Plaintiffs are entitled to feel aggrieved and to seek legal counsel. Some, however, have ulterior motives.

Plaintiff attorneys are “good Samaritans.” They work for a contingency fee. This invites ulterior motives; however, because these attorneys bear the cost, motives do not matter. Only the value of a case matters and there is artificial intelligence to weed …

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Healing from the pandemic’s mental toll

Conditions
October 26, 2025

The pandemic changed us in ways that cannot be measured by infection rates alone. Beyond the physical toll, it left lasting scars on our mental health. Fear, uncertainty, and isolation became daily realities. As a health professional and researcher, I wanted to understand how people could begin to heal. During my doctoral work, I studied adults who engaged in different wellness practices after the pandemic. Some found relief in nature: …

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Choosing the right doctor: How patients can take control of their care [PODCAST]

Podcast
October 25, 2025
YouTube video

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Professor and patient advocate Edward G. Rogoff discusses his article “How to choose the right doctor for you.” In this episode, Edward explains why selecting the right physician is one of the …

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The infectious hypothesis of Alzheimer’s disease

Conditions
October 25, 2025

When I tell colleagues that I offer Valtrex (valacyclovir) and low-dose lithium orotate to patients worried about developing Alzheimer’s, the silence in the room thickens. Someone always asks, “Where’s the randomized controlled trial?” That’s exactly the problem. We keep waiting for perfect evidence while the disease eats away at people’s brains.

I’m an internist and lipidologist who’s spent years watching the medical establishment chase the wrong villains, like cholesterol, salt, …

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A pediatrician on the lead contamination crisis

Physician
October 25, 2025

I shake my head in disbelief. Is this really happening in the United States? As a pediatrician and public health advocate, I believe we are witnessing the literal systematic dismantling of our health care system.

Case in point: the federal government’s mishandling of two recent lead contamination crises (in Michigan and Wisconsin). These failures not only expose children to preventable toxic harm, but also reveal a deeper breakdown in democratic accountability …

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Physician burnout as a relationship crisis

Physician
October 25, 2025

When people discuss physician burnout, they often reduce it to a workplace issue: long hours, endless charting, electronic health records that seem never to end, and patient loads that test the limits of human capacity. The solutions we’re offered sound deceptively simple: take a vacation, practice gratitude, do yoga, and meditate more. It’s as if wellness could be squeezed into the fifteen minutes we have left after charting at midnight. …

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The making of a rested healer

Physician
October 25, 2025

I didn’t realize how exhausted I was until everything stopped. First came burnout, the quiet unraveling so many physicians know too well. Then grief followed. I lost my mother unexpectedly to an aggressive cancer and, three years later, my father after years of caregiving through advanced Parkinson’s disease. These losses shattered not only my heart but the way I viewed my life and work. For years, I practiced medicine within …

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The decline of the doctor-patient relationship

Physician
October 25, 2025

Something is wrong with our health care system. Our country spends more per capita than any other developed nation, yet we have some of the worst health care outcomes. Rising costs are making health care prohibitive. Access to the system is becoming a growing concern. Medical care has become bureaucratic, bulky, and inefficient. I am a retired physician, a urologist, who has observed the health care system from outside medical …

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The secret illnesses of U.S. presidents

Physician
October 25, 2025

Presidents are not immortal. But for much of American history, their bodies have been treated as state secrets, curated, concealed, and choreographed for public reassurance. When illness is hidden, the cost is not just clinical. It is geopolitical.

Warren G. Harding: collapse before the scandal

President Warren G. Harding died suddenly on August 2, 1923, at age 57, while touring the country on his “Voyage of Understanding.” He collapsed in San Francisco’s …

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A psychiatrist’s scarlet letter of shame

Physician
October 25, 2025

I put it on one night among tears and grief. It slid onto my skin like butter, like it was meant for me. It hugged my torso and clung to all the wrong places. The truth is, I had worn it before. I am unsure exactly when I last stopped wearing it. Unlike the donning of the letter, the removal is much quieter. I probably did not realize exactly when …

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How sleep, nutrition, and exercise restore physician well-being [PODCAST]

Podcast
October 24, 2025
YouTube video

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Physical therapists Kim Downey, Ziya Altug, and Shirish Sachdeva discuss their article “How physicians can reclaim resilience through better sleep, nutrition, and exercise.” In this episode, Kim, Ziya, and Shirish explain how …

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The physician mental health crisis in the ER

Policy
October 24, 2025

The numbers are staggering. Americans made 139.8 million emergency department visits in 2024, that is 42.7 visits per 100 people, with behavioral health issues driving an unprecedented surge. Behind these statistics lies a harsh reality: depression, a leading cause of ill health and disability worldwide, is overwhelming our emergency departments with cases they were never designed to handle. This tsunami of mental health crises creates a vicious cycle. …

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