“If you ask what they like about their surgeon and they only say they are nice? I don’t want a nice person.” This sentiment comes from Dr. Oz, a boarded and licensed thoracic surgeon, and was posed to the house of medicine at the 2025 House of Delegates Interim Meeting.
I have grappled with what being a good surgeon means to me. Our training would have us believe that a good …
Why a nice surgeon might actually be a better surgeon
The American Board of Internal Medicine (ABIM) made headlines in late 2024 when it announced the elimination of its unpopular two-year Maintenance of Certification (MOC) point requirement. On paper, this looked like progress, a gesture toward simplification after years of criticism from physicians who felt trapped in an expensive, time-consuming cycle that added little value to their actual practice. But beneath the surface, the reform raises a harder question: Has …
Did ABIM MOC reform actually fix the problem for physicians?
Scrotal pain in young men is a frequent reason for emergency department visits and urology consultations. While many underlying causes are benign and self-limiting, others, most notably testicular torsion, represent true urologic emergencies in which delayed intervention can result in irreversible testicular damage.
The clinical challenge lies in distinguishing conditions that allow for short-term observation from those requiring immediate evaluation. This distinction is particularly important in adolescents and young adults, …
Scrotal pain in young men: When to seek urgent care
Canada prides itself on having a strong public health system, yet we continue to treat oral health as optional. Dental disease occupies a peculiar niche in health care: scientifically essential, yet structurally marginalized. We know that chronic gum inflammation is linked to heart disease, stroke, diabetes complications, and even adverse pregnancy outcomes. Yet it remains largely detached from how we think about preventing chronic illness.
This disconnect isn’t caused by a …
Mobile dentistry: a structural redesign for public health
For many older adults living alone, a smartphone is not a convenience. It is a lifeline.
In elder care meetings, we often discuss telemedicine, wearable sensors, and remote monitoring systems. We focus on dashboards and data. Yet in our pursuit of high-tech solutions, we frequently overlook the most widely used and emotionally loaded digital tool already resting in older adults’ hands: the messaging app.
In Taiwan, as in much of Asia, LINE …
Technology for older adults: Why messaging apps are a lifeline
Most recognize me for extolling the virtues of deductive reasoning in medical malpractice case review, but I never explain why I am so worked up over medical malpractice. Some would point out, “There are only 17,000 malpractice lawsuits filed per year out of a total of perhaps as many as 40 million lawsuits filed nationwide. Therefore, medical malpractice represents 0.04 percent of all lawsuits filed. What’s the big deal?” …
Are medical malpractice lawsuits cherry-picked data?
As of January 1, 2026, the American health care system is in crisis. People can no longer afford their health insurance premiums or even to afford to pay for any health insurance. Recently, a 62-year-old self-employed friend of mine saw his premiums increased tenfold in a single cycle. I am lucky that I am over 65 and have Medicare insurance as well as a pension from my employment. Millions of …
Accountable care cooperatives: a 2026 vision for U.S. health care
An excerpt from What the Physician Whispered.
You are looking at me, little one,
perhaps wondering who I might be.
Even though I might seem friendly,
you seem wary and frightened, not yet
used to seeing strangers and busy places.
Someone thought maybe I might help save you.
I offer to give you poison.
They have not told you, because they do not know
how sick you really are, meaning how close you are
to an unexpected conclusion that …
The Chief Poisoner: a chemotherapy poem
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Health care executive Jason Griffin discusses his article “The digital divide in rural health care.” Jason explains how rural providers in the U.S. face critical infrastructure failures and staffing shortages that threaten …
Collaborative partnerships save rural health care from collapse [PODCAST]
The use of MRI body scanning as a preventative tool was highlighted by the president’s recent rope-a-dope with the media. Community practice whole-body MRI businesses now exist, local entrepreneurs directly marketing these services to the public. These scans are not reimbursable by traditional health payers.
The attraction of MRI is its lack of ionizing radiation, as well as its proven sensitivity to a variety of pathologies. Example: Detection of breast cancer …
Whole-body MRI screening: political privilege or future of care?
In medicine, waiting is normalized. We’re trained in it. Praised for it. We learn to delay sleep, meals, vacations, and emotions. We delay joy. Rest. Fulfillment. Relationships. Children.
From the very beginning, we’re taught that waiting is a virtue. That endurance is professionalism. That sacrificing our own needs is a sign of how much we care.
During training, we wait (for sleep, for food, for recognition). We wait for the pager to …
Why doctors must stop waiting and reclaim their lives
By 11 p.m., my clinic was dark but my brain wasn’t. I found myself scrolling through my schedule for the next day: 22 patient visits, a pile of unsigned notes, two meetings squeezed into “lunch,” and a post-call morning that somehow still started at 7 a.m. None of these tasks were unusual, but what struck me was the growing tightness in my chest and the realization that I had quietly …
The hidden link between circadian rhythm and physician burnout
Addiction is no longer a clinical category. It has become the cultural baseline.
We used to think of addiction as something that happened to a few vulnerable people who “couldn’t handle” life’s pressures. Now it’s woven into everyday existence. Most of us reach for our phones before we reach for a breath. We chase stimulation without noticing we’re chasing. We live in a world that subtly trains us to crave.
Somewhere along …
Why addiction is no longer just a clinical category
As an internal medicine physician, I’ve spent years watching one quiet assumption extract more unpaid labor from physicians than anything else in our system. It’s not charting. It’s not meetings. It’s not metrics.
It’s call.
I wrote a post on my LinkedIn page about my thoughts regarding call. It resonated with many physicians, and I received many messages. It became clear that being “on call” is something that is rarely spoken about …
Physician on-call compensation: the unpaid labor driving burnout
There is a general undercurrent of dissatisfaction with health care in America that is, shall we say, palpable. Many studies and statistical analyses support this notion but I think a broader view is both valuable and less abstract than a data set. We could go measure the angle of the Leaning Tower of Pisa and evaluate the foundational errors, but it doesn’t take that level of granularity to see that …
The real cost of U.S. health care dissatisfaction
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Physician executive Christina Johns discusses her article “Modernizing health care with AI and workflow.” Christina explains how clinicians in the U.S. are facing unprecedented burnout due to administrative burdens that detract from …
Artificial intelligence offers a lifeline to overwhelmed clinicians [PODCAST]
An excerpt from 99 Ways to Die: And How to Avoid Them.
In response to this chapter, I expect to receive a battery of soaking wet letters from infuriated marine biologists, since each species deserves their own chapter, but my editor cut me off.
Flamboyant cuttlefish
The flamboyant cuttlefish is not to be confused with the flamboyant cuddle-fish, which does not exist. The cuttlefish, Metasepia pfefferi, looks like an orchid that ran …
The most venomous sea creatures to avoid
Over the past decade, there has been a marked rise in adolescents and adults seeking autism evaluations. Many of these individuals are intellectually intact, verbally fluent, and professionally capable, yet have lived for decades with persistent social fatigue, sensory sensitivities, difficulty interpreting unspoken social rules, emotional overwhelm, rigid or all-or-nothing thinking, challenges with transitions, and extensive masking or camouflaging behaviors, all without a diagnosis. When they finally seek clarity, the …
Adult autism assessment: ADOS-4 vs. narrative interviewing
“The danger isn’t that AI is too powerful; it’s that we stop questioning it.”
Artificial intelligence in medicine is often described as revolutionary, capable of diagnosing disease, predicting deterioration, and automating once-human decisions. But I want to suggest a different lens, one drawn not from technology, but from history.
Let’s go back to ancient Greece.
There, leaders turned to the Oracle of Delphi not for …
AI in medicine risks: the new Oracle of Delphi?
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