This morning I’m celebrating. I did something last night for the very first time. I walked on stage alone, opened my mouth, and sang. I’ve marveled at every singing performance I ever attended, wondering, how do they do that? And now, I can say, I have.
I’m a high-achiever. I say that with a bit of embarrassment. It feels like a pejorative term: the student who does it all, who joins …
Physician perfectionism can keep you from ever trying
My LinkedIn feed has been flooded with discussion about a recent Nature Medicine study showing that general-purpose large language models outperform specialized clinical AI tools on medical benchmarks. Clinical informatics leaders are calling it a wake-up call for health care, pointing to a timeless truth: Technology rarely fails at the technical layer. It fails because we don’t map how the work actually happens on the ground.
As a clinician working in …
A South Sudan doctor on the AI health equity gap
Recent product announcements from major wearable companies showcased the polarization of views on the direction of well tech. During the past two weeks, Google has made significant moves to deepen its health AI ambitions, and Whoop has doubled down on positioning its device as a clinical-grade monitoring tool. Both companies represent serious, well-resourced bets on the future of consumer health. And watching these developments closely, I’ve found myself thinking about …
AI versus clinicians is the wrong health care question
As pediatricians, we enter patients’ lives at moments of uncertainty. You learn how to listen for what is said and what is not said. You walk guardians through fevers, developmental milestones, and the thousand small worries that come with raising a child. Over time it all feels comfortable. Routine.
Then you become the parent. The questions you have answered so many times drip with new urgency, and your own uncertainty. Sleep, …
Becoming a physician mother changed how I practice
A hospital credentialing committee is weighing an application for surgical privileges. Someone on the panel does what any of us would do: They type the surgeon’s name into Google, and because they are being careful, they add one word: “lawsuit.” A malpractice complaint surfaces on the first page. It lays out the allegation in plain language. What the panel does not see, anywhere on that page or the one after …
A dismissed malpractice lawsuit can still cost privileges
The longer I spent in the mental health system, the harder it became to remember who I was outside the pages of my medical record. Because when people stopped referring to me as the young girl I was, and instead as a diagnosis or simply as “the patient in bed 27,” how was I supposed to remember who I was outside those hospital walls? The staff had read through my …
Reduced to a diagnosis: I was the patient in bed 27
An excerpt from Blood Poison: The Untold Story of Sepsis.
Eduardo’s blood pressure failed to respond to one fluid bolus, then another, and another. We instructed his nurse, Jenny, to start a vasopressor called dopamine while Alex and I prepared to place a central venous catheter in Eduardo’s internal jugular vein. (Dopamine also increases heart rate and cardiac muscle contractility. Although doctors classify drugs as vasopressors and inotropes, many of …
The night septic shock took a patient we fought to save
Patient details have been changed and combined where necessary to protect privacy.
This week, I evaluated two young people who had recently been hospitalized after developing psychosis in the setting of heavy cannabis use. Both had been discharged with serious psychiatric diagnoses and multiple medications. Both families were frightened. And in both cases, the central clinical question remained insufficiently answered: Was this the onset of a primary psychiatric disorder, or was …
Is it cannabis-induced psychosis or bipolar disorder?
Open almost any surgical journal this year and you’ll find a new AI model. A neural network that predicts anastomotic leak. A risk calculator trained on a single institution’s registry. A computer-vision system that labels the phases of a laparoscopic cholecystectomy. A bespoke tool for predicting graft patency, rupture risk, or readmission. Each is presented as a small, hard-won victory where domain experts encode clinical knowledge into a tightly scoped …
Clinical AI tools are losing to general-purpose models
I just came off the stage at NPAC 2026 in Charlotte, where I presented to a room full of physician advisors on practical AI strategies for expanding bandwidth. The questions afterward told me everything I needed to know about where this profession stands right now.
Nobody asked whether AI was coming. They already know it is. They asked something more honest than that: How do we use it without losing the …
AI will not replace physician advisors. Volume will.
When most people hear the words “Ramsay Hunt syndrome,” they think of a temporary illness. A rash. A facial droop. Some antivirals. Then recovery. That is the version often described in textbooks.
It is not the version I live with.
Years ago, I developed Ramsay Hunt syndrome. Like many patients, I assumed that with treatment and time I would recover and return to my normal life.
Instead, I entered a world I never …
Chronic Ramsay Hunt syndrome doesn’t end with the rash
Medical malpractice in the United States has evolved into a system plagued by substantial problems. Each year, the National Practitioner Data Bank (NPDB) reports statistics on an average of 13,000 medical malpractice lawsuits that are litigated. However, these are awards against practitioners, which account for one-third of all medical malpractice lawsuits that are litigated. Hence, 40,000 medical malpractice lawsuits are litigated.
Another source, Justpoint, reports that as many as 85,000 medical …
The medical malpractice system rewards delay
Recently, while watching Influenced, a satirical film about wealthy influencers and socialites, I heard the words “Food Allergy Ball” as part of a skit. The audience was expected to laugh. I couldn’t. It wasn’t because I lack a sense of humor. It was because those words immediately caused my brain to recall a memorial slide for those who passed at a real Food Allergy Ball.
That wasn’t the only scene that …
Food allergy stigma and the names on a memorial slide
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For more than two decades, admission, discharge, and transfer (ADT) alerts have served as the backbone of automated patient-activity notification in U.S. health care. Designed to give clinicians and care managers a real-time heads-up when patients interact with and move through the health care system, they remain a workhorse of care coordination, and inside the facilities a care team is directly connected to, they often perform exactly as intended.
However, …
How clinical alerts deliver a fuller view of patients
My name is Tony Grandelis. I’m an OB/GYN hospitalist, a medical educator, and a person in long-term recovery from substance use disorder. Through my brand Recovering Healthcare, I explore what addiction recovery has taught me about fixing a broken health care system, one principle at a time. Today, I want to talk about resentments, which are, in my opinion, some of the most under-recognized causes of burnout in medicine.
In recovery, …
Resentment in medicine is a leading cause of burnout
After performing more than 600 IVF cycles a year for nearly two decades, I’ve noticed something that has little to do with embryology and everything to do with expectations. The couples who cope best with this process aren’t necessarily the ones with the best prognosis. They’re the ones who walked in with a realistic picture of what they were about to go through.
I wish more of my colleagues talked about …
What I wish couples knew before their first IVF cycle
Every physician carries the imprint of their training. Some of those imprints are gifts: a clinical insight, a way of listening, a habit of precision. Others are burdens we never asked for. We inherit not only the wisdom of our mentors, but also their blind spots, their anxieties, and sometimes their failings.
Early in my career, I trained under a mentor who, at the time, was widely admired. He was charismatic, …
Guilt by association in medicine: My mentor fell, not me
When we think of health care innovation, our minds typically gravitate toward clinical breakthroughs: state-of-the-art robotic surgeries, cutting-edge wearables, or novel pharmaceutical treatments. However, one of the most profound transformations in the modern health care sector is happening behind the scenes.
The integration of artificial intelligence (AI) and automated technologies into health care administration is quietly revolutionizing how facilities operate. By alleviating the massive administrative burden placed on medical professionals, these …
How AI in health care administration eases burnout
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You feel guilty for calling in sick, taking earned vacation, or setting a boundary at work. What if that guilt was never really yours? Christie Mulholland is a palliative care physician and certified …
Doctors burn out from a guilt that was never theirs [PODCAST]
Every day in family meetings across the United States, we clinicians are delivering difficult truth to a family: Their loved one is nearing the end of life, and comfort-focused care is the appropriate (and desired) next step. Goals are aligned. The clinical picture is clear. And then the conversation hits a wall that has nothing to do with the practice or the art of medicine: Our patient cannot go home. …
Why Medicare hospice coverage fails the dying
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