The first day I walked into my residency clinic, I realized this was the part of medicine I understood the least. The waiting room was full, and every patient carried not just a diagnosis but the weight of a system already stretched thin. We learned to triage, to document, and to move quickly. But we did not learn how to lead, how to build continuity, or how to see the …
We ran as fast as we could. I glanced up occasionally at the nurse straddling my patient, her blonde waves obscuring her face as she furiously attempted to restart a non-beating heart. We pushed the hospital bed down hallways and around corners, narrowly missing people-filled stretchers lining the Emergency Department. I stood in the back while the experts took over. If she was ready to leave this world, I wanted …
The most powerful lesson I am learning in medicine whispers against the roar of constant intervention. It is the art of “”unmedicine”: the wisdom that the best care can often mean doing less. I entered medical school envisioning a future of decisive action. Yet, my clinical experiences have painted a more complex picture. I’ve seen a physician spend a full consultation gently steering a patient away from an unnecessary MRI, …
Carrier screening has outgrown the language we still use to explain it.
For years, clinicians told patients they were either “a carrier” or “not a carrier.” But as the science has evolved, this binary approach is not only outdated; it is increasingly misleading.
Genetic carrier screening has entered a new era, and our counseling must evolve alongside it.
For decades, carrier screening was offered selectively based on ethnicity. Ashkenazi Jewish individuals were screened …
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Internal medicine physician Augusta Uwah discusses her article, “The dying man who gave me flowers changed how I see care.” She shares the emotional story of a terminally ill patient whose simple …
In modern medicine, the use of plain language is a fundamental clinical skill. This is especially critical when health decisions can profoundly affect a patient’s life, impacting their financial stability, ability to work, personal independence, and mental well-being, as well as their capacity for managing daily care, recognizing warning signs, and adhering to treatment plans. Considering the patient as a partner in their care, an informed decision can only be …
This article is sponsored by MagMutual.
Selecting the right medical malpractice coverage is one of the most important professional decisions a physician or practice administrator can make. Even if you feel confident in your current insurer, it’s wise to revisit your options periodically. The medical malpractice insurance market continues to evolve. New liability coverages emerge, and some carriers now offer …
In examination rooms across the country, the foundations of medical practice are being eroded. Physicians navigating the opioid crisis are forced to choose between our ethical duty to alleviate suffering and the legal risk of sanction. When we provide reproductive care, the patient-physician relationship is being superseded by political ideology, with devastating consequences. When we follow evidence-based guidelines for gender-affirming care, we face legislative intrusion that substitutes political agendas for …
The first thirty years of my life were about becoming a doctor. I grew up in a middle-class family in a safe neighborhood with good schools and steady routines. My parents valued hard work and education, and I learned early that if you studied, followed the rules, and kept your head down, good things would follow. Private Catholic elementary school, public high school, then college and medical school. Every step …
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Hematology-oncology physician Adeel Khan discusses his article, “Universities must tap endowments to sustain biomedical research.” He explains how declining federal support for the National Institutes of Health threatens America’s position as a …
I was trained to treat heart disease like a plumbing problem. Cholesterol clogs the pipes, statins clear them out. LDL goes down, we high-five each other. But what if we’ve been chasing the wrong culprit all along?
A recent Japanese study looked at 50 plaques removed during coronary atherectomy. Every single one of those plaques tested positive for Chlamydia pneumoniae by PCR or immunostaining. That’s not “some,” or “most.” That’s …
I entered medicine not just to treat illness, but to confront injustice. I wanted to be a force for good, battling death, yes, but also misinformation, institutional neglect, and the quiet superstition that children with developmental disabilities were somehow less worthy of coordinated care. That conviction led me to align my career with the legacy of Eunice Kennedy Shriver, whose advocacy gave rise to the Special Olympics and helped shape …
The service entrance doors slid to the right and, as Molly Humphreys and I exited the Berkeley Medical Center, we stepped into an unseasonably warm evening. “It’s the golden hour,” Molly said as we surveyed our surroundings and removed our masks, exposing flat faces with creased noses. Behind us stood a cold, somber hospital and we were engulfed in an empty parking …
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The highway from western North Carolina to northeast Georgia is dark at five in the morning. One of my long-time patients grips the wheel and drives two hours for a 15-minute visit with the doctor she trusts. She could have met me by video from her kitchen, but the law forbids it. The moment she crosses that state line, I lose the right to care for her. That’s not medicine. …
I wrote last year about physician suicide as a silent epidemic. The silence is not lifting. The losses are getting closer. The grief is heavier. We all feel it. This month, we lost Dr. Nolan R. Williams. He advanced care for severe, refractory depression and pushed neural stimulation science forward. Then he died by suicide. His death landed like a shock wave across medicine and beyond and the …
This morning marked a sad ending to my night shift. It was, or rather, had been, at a small community hospital in a tiny New England town, nestled in the backyards of where I was born and raised. But in just a few days, it will cease to exist as a hospital and morph into a stand-alone ER. Before I wrapped up my final shift, I sat down with a …
In December 2017, a fellowship-trained neuroradiologist in good standing was pulled off his teleradiology shift mid-interpretation by the police, put in handcuffs, and taken to jail. He was accused of reading ultrasound studies too quickly, approximately three to five minutes per interpretation, inconceivable to the district attorney and their hired plaintiff radiologist expert. Because there were Medicaid patients involved, he was said to be defrauding the government. The allegation was …
Extreme longevity
People claim they want to live to be 100, yet is that a good thing? How you get there may make all the difference. Here’s my take on Blue Zones and the prospect of living to 100. “Blue Zone” is a nonscientific term popularized twenty years ago by Dan Buettner, a National Geographic explorer who studied five geographic regions where many people live to be over ninety or 100. …
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Internal medicine physician Rajeev Khanna discusses his article, “I passed my medical boards at 63. And no, I was not having a midlife crisis.” He shares his journey of studying for the …
As a founder developing AI systems for mental health support, I have wrestled with a fundamental question: How do we use AI to expand access while maintaining patient-provider trust? Building an AI Mental Health Copilot has shown me that the ethical challenges are as complex as the technical ones, and far more consequential. The mental health crisis demands innovation. AI copilots offer scalable, always-available support to bridge care gaps caused …
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