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When a doctor shows real kindness, does it change how a patient heals? For Randy McNeely, the answer arrived the day his wife was diagnosed with cancer, and the calm, caring doctors who …
A doctor’s kindness changed how my wife survived cancer [PODCAST]
Autism care in the United States did not collapse overnight. It collapsed because the discipline designed to guide it, developmental-behavioral pediatrics, stepped back while other systems stepped forward. That silence created a vacuum, and applied behavior analysis (ABA) filled it. Not because ABA offered the most humane or developmentally grounded model, but because it was present, reimbursable, and organized. Silence did the rest.
I saw the consequences of that silence in …
Why autism care collapsed into one model
Military sexual trauma (MST) affects an estimated 1.4 million U.S. veterans and is one of the most consequential noncombat-related health burdens associated with military service. Military trauma is still commonly viewed through the lens of combat exposure, but MST is a distinct form of military trauma involving interpersonal violation, power imbalance, disrupted trust, and long-term mental and physical health consequences.
For clinicians, MST should not be understood simply as another cause …
Military sexual trauma is not just another cause of PTSD
Ask a physician what the biggest business risk to their practice is, and most will land somewhere familiar. A lawsuit. A bad payer contract. A denial spike that guts a quarter’s revenue.
It is none of those. For a solo or independent physician, the single biggest risk to the practice is the physician’s own unavailability. Not the clinical kind anyone insures against. The plain fact of not being there to run …
The biggest risk to your practice is you
The 764 Network is an unprecedented threat to pediatric health. As an EM physician, and as a parent that has seen the effects of 764 firsthand, we know the dangers that online networks like this pose.
The 764 Network was founded by Texas teenager Bradley Cadenhead. Cadenhead regularly blackmailed and sextorted children as he navigated multiple online platforms using hundreds of accounts. He rapidly gained online notoriety for forcing minors …
The 764 network warning signs clinicians miss
Cardiac electrophysiology is uniquely demanding. Even in the most experienced hands, procedural risk cannot be eliminated. Yet in malpractice litigation, adverse outcomes are frequently misinterpreted as evidence of negligence. This conflation threatens both physician practice and patient care. A more precise articulation of the standard of care in electrophysiology is essential.
Under tort principles, malpractice requires proof of duty, breach, causation, and damages. The standard of care is defined by the …
Electrophysiology malpractice: conduct, not outcome
I have previously written that “not all physicians are nice.” Some physicians (a tiny minority) in private practice hold out the promise of partnership, paying physicians below-market wages until they get to the golden ring. Then, they terminate these physicians before they are made partners. As I noted then:
I have been representing physicians for over forty years, and the vast majority of the people I work with are genuinely …
The partnership offer that cost her $325,000
For millions of people living with obesity, FDA-approved GLP-1 medications have created new opportunities to improve health, reduce the burden of related chronic diseases, and receive evidence-based treatment for a condition that has too often been dismissed as a matter of willpower. At the same time, extraordinary demand for these therapies has fueled the rapid growth of compounded alternatives that are often marketed as less expensive, personalized, or equivalent substitutes. …
Compounded GLP-1 drugs are not the same as approved ones
I recently listened to a heated but friendly debate among medical students about why some of their peers seemed to struggle far more than others. The underlying assumption was simple enough: they had the same twenty-four hours, sat for the same exams, moved through the same clinical rotations, and endured the same demands. If everyone was being asked to do essentially the same thing, why did some people seem to …
Why medical student mental health is not about willpower
I still remember the mist that morning. Not because it was unusual, but because some mornings refuse to be forgotten.
I was approaching the end of my second year of surgical residency. The nervousness of my first few months had slowly given way to confidence. I could evaluate patients independently, formulate plans, and perform a growing number of procedures. I believed I was learning how to become a surgeon.
What I did …
You could have been professional, but you chose kindness
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Fertility specialist and Montgomery Fertility Center founder Oluyemisi “Yemi” Famuyiwa discusses the article “What no one tells you about fertility, from a doctor.” Yemi discusses the article through a compassionate look at …
What no one teaches you about fertility before you need help [PODCAST]
The steel cage door slams shut.
Its metallic echo reverberates through the arena,
a warning bell for a contest already decided by those selling tickets.
Under the harsh lights stands the patient.
Thin, weary, clutching a stack of medical records
instead of weapons.
Across the cage wait towering opponents.
Corporate health systems, their muscles swollen
with profits and policies.
Government regulations, thick rulebooks
wrapped around their fists.
Pharmaceutical giants, draped in sponsorship banners,
their pockets heavy with the cost of survival.
The crowd …
A poem for everyone fighting the health care system
I grew up as the son of a dead Air Force officer who made the ultimate sacrifice for his country. In Boston in the 1970s, that lineage didn’t shield me. It marked me. I walked around with a crewcut, government-issued BCG glasses (“birth-control glasses,” as every military kid knew), and a stubborn refusal to follow the crowd. That was enough to get me spat on more than once.
Those moments didn’t …
The physician who refused to follow the crowd
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I did not expect the red-carpet treatment. My illness came on abruptly, without a prodrome and without the courtesy of localizing symptoms, no cough, dysuria, or obvious source of infection.
One weekday morning, after stepping out of a hot shower, I collapsed onto the bathroom tile like a heap of wet seaweed. I attributed it to overwork, dehydration, and the predictable consequences of caring for everyone except myself. By the time …
The physician as patient nobody wanted to listen to
Recently, I learned that access to a clinical artificial intelligence platform had been restricted within my training environment. My first reaction was not anger. It was curiosity.
The decision may have been entirely reasonable. Health care institutions have legitimate concerns about privacy, security, liability, accuracy, and governance. Those concerns deserve thoughtful consideration. But the experience left me wondering about something much bigger than any individual hospital or software platform. If physicians …
The real barrier to evidence-based medicine is access
Every day, hospitals across America perform one of medicine’s greatest achievements.
A family arrives anxious and uncertain. A baby is born. Skilled physicians, nurses, therapists, and support staff guide mother and child safely through pregnancy, birth, and recovery. Before discharge, families receive careful instruction on feeding, safe sleep, car seats, medications, warning signs, and follow-up care.
In Connecticut, that commitment to the discharge moment has grown even further. Hospitals are now sending …
Newborn brain development starts at discharge
Recently, a rocket company went public on the Nasdaq, and by the time the bell closed, its founder had become the first person in history worth a trillion dollars. I read about it on a borrowed phone outside the pediatric ward at Al Sabah Children’s Hospital in Juba, South Sudan, waiting for the otoscope to free up.
I’m not writing this out of anger. I want to say that clearly. I …
A doctor in South Sudan on a trillion-dollar Friday
Artificial intelligence is forcing medicine to make a choice that has received surprisingly little attention. Should AI be designed to replace increasing portions of clinical judgment? Or should it be designed to elevate it? Much of today’s discussion assumes these are the same objective. They are not. One seeks to substitute human reasoning. The other seeks to strengthen it.
Unfortunately, the momentum today is largely toward replacement. We read almost daily …
AI should elevate clinical judgment, not replace it
In 2019, Kentucky lawmakers passed the Human Life Protection Act (2019 HB 148), a law designed to take effect if Roe v. Wade were overturned. On June 24, 2022, following the decision in Dobbs v. Jackson Women’s Health Organization, that law went into effect, banning abortion in nearly all circumstances. Today, the only exception permitted is for serious medical risk to the pregnant patient. There are no exceptions for rape …
Kentucky’s abortion ban has no rape and incest exceptions
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Women doctors joke about being cursed with every complication, but what if the job itself is quietly damaging their health? Jessie Mahoney, a pediatrician and certified coach, returns to share her own story …
Why women doctors get sick and blame themselves for it [PODCAST]
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