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Internal medicine and pulmonary physician Bharat Desai discusses his article “How Acthar Gel became a $250,000 drug.” Bharat shares the shocking moment he realized an obsolete pituitary extract from 1952 was being …
Corporate greed and medical complicity fueled a $250,000 drug [PODCAST]
For decades, many have documented the decline of the physical exam. As imaging grew more powerful, labs more precise, and algorithms more accurate, the stethoscope and reflex hammer faded in importance. Some even speculated that technology would eventually make hands-on diagnostic skills obsolete.
But the next era of medicine may flip that prediction on its head.
Picture a future where artificial intelligence participates in nearly all patient management decisions. This seems inevitable …
The physical exam in the AI era
America’s physician shortage is no longer a distant projection. It is happening now, steadily, one resignation, early retirement, and practice closure at a time.
A nationwide, longitudinal analysis published in Annals of Internal Medicine tracked more than 712,000 physicians caring for Medicare patients over a decade and found a troubling trend: Physician attrition from clinical practice rose from 3.5 percent in 2013 to 4.9 percent in 2019, across every specialty, …
Physician attrition rates rise: the hidden crisis in health care
A recent Johns Hopkins study has reignited that debate. The research documents rapid growth in concierge and direct primary care practices and warns that these models may worsen access to care.
That framing feels intuitive. It is also incomplete.
It assumes that traditional primary care access was functioning before physicians began moving into fee-based models. It was not.
Long before concierge and direct primary care gained traction, primary care access had already …
Concierge medicine access: Is it really the problem?
Frivolous medical malpractice lawsuits are endemic and infect everyone whether they realize it or not. The greed of plaintiffs, attorneys, medical experts, and malpractice carriers, coupled with the ineptitude of the tort system, causes avoidable costs. Everyone pays the price.
Some plaintiffs sue for medical malpractice just because they harbor a grievance against a doctor and their claim has no attributable merit. Plaintiff attorneys, who are looking for business, advertise …
How frivolous lawsuits drive up health care costs
The discomfort I felt around supervising did not arise in the clinic. It arose while reading the agreements meant to define it.
Supervisory agreements. Collaborative designations. Regulatory language that needed to be reconciled (carefully, deliberately) because names, roles, and obligations matter. Like many physicians, I have signed these documents countless times. But reading them slowly, rather than reflexively, produced an unexpected unease, one that felt structural rather than personal.
The language was …
The shifting meaning of supervision in modern health care
I wanted to be at the top. Clinical ladder 4 was the top. You couldn’t get any higher achievement as an ICU nurse than this.
There were many requirements to obtain this:
I checked all the boxes, every year. It was hard work. And tiresome. The compensation for …
Emotional abuse recognition: a nurse’s story
When we think of peacekeeping missions, images of armored vehicles and blue helmets often dominate the narrative. Rarely do we picture the quiet, relentless battle fought within the walls of a makeshift hospital, where saving lives becomes an act of defiance against chaos. Yet, in Abyei, Sudan, that was our reality. We arrived expecting logistical challenges, but nothing prepared us for the disarray that greeted us at the UN Level …
Peacekeeping medicine: Saving lives in Sudan’s forgotten hospital
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Certified coach and professor Kathleen Muldoon and co-founder of Ryan House and Children’s Respite Homes of America Jonathan Cottor discuss the article “The need for pediatric respite care.” Kathleen shares the personal …
Pediatric respite homes provide a survival mechanism for struggling families [PODCAST]
At the height of the COVID-19 surge, many hospital leaders faced moments they will never forget. Beds were nearly full. Staff were exhausted. Supplies that once felt routine suddenly became scarce. In those moments, decisions had to be made quickly, often based on experience, instinct, and whatever information was available at the time.
We like to believe that good leadership means trusting our gut. In clinical medicine, intuition matters. Years of …
The role of operations research in health care crisis management
For decades, medicine has spoken the language of hazard ratios, Kaplan-Meier curves, and median survival differences. We have become fluent in the grammar of precision oncology, genomic signatures, driver mutations, targeted therapeutics, and real-time disease monitoring. But there is one language we have not yet mastered: the language of the patient’s lived experience.
Personalized medicine cannot stop at matching the right drug to the right tumor. It must also include personalized …
Personalized scientific communication: the patient experience
An excerpt from Wipe Out, Rise Up: A Surf Session In Being a Leader, Pushing Past Limits, and Sustaining Health. Copyright © 2024 Scott Ellner. Published by BrightRay Publishing. All rights reserved.
Growing up in Southern California, I was well-acquainted with the waves of the Pacific Ocean. Cold water from Alaska flowed down the coast, meeting the warm, sunny climate of Los Angeles, roasted by the heat of the Santa …
From law to medicine: Witnessing trauma on the Pacific Coast Highway
Early in medical school, a professor warned us: “Never prescribe for someone who isn’t your patient.” He shared a story of writing a simple antibiotic for a friend who later developed Stevens-Johnson syndrome, a devastating outcome that haunted him long after. His message was clear: There is a bright line between caring and causing harm.
Fifteen years out, we now understand just how blurry that line really is.
“First, do no harm” …
Why doctors struggle with treating friends and family
This is not a detailed story like the ones I usually write. It’s just a little breeze of warmth that touched my soul and heart, and I wanted to share it with you.
I had been so overwhelmed over the past weeks, taking care of so many patients for months and staying in a place where there was no one to listen to me. In fact, I was the only listener …
The emotional toll of leaving patients behind
With the holiday season upon us, joy, warmth, and delicious food fill our homes. While we enjoy those festival meals, our own “life-highway” vessels quietly shoulder the burden of all the fats and sugars we consume. Alongside the happiness of the season comes an overlooked strain on our arteries. What strikes me even more, as a vascular specialist, is a recent study from the University Hospital at Downstate in …
Peripheral artery disease prevention: Saving limbs and lives
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Orthopedic surgeon Kevin J. Campbell discusses his article “Health care is having its Yahoo moment.” Kevin explains how the current medical system is stuck in an obsolete pipeline model similar to early …
Artificial intelligence ends the dangerous cycle of delayed patient care [PODCAST]
As a 93-year-old physician, I am well acquainted with the ravages of aging and the continuous adaptations we all must make to accommodate its increasing demands. One area that is particularly troublesome is nocturia with repeated, late-night calls to the toilet. This is not only an issue of disturbed sleep, but also of safety. Nocturia involves leaving my bed, turning on a light, and making my way to the bathroom, …
A simple nocturia management technique for seniors
In a valuable episode of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, spoke with Dr. Matthew Provencher, an orthopedic surgeon, Navy veteran, former team physician for the New England Patriots and Boston Red Sox, and current partner at The Steadman Clinic in Vail, Colorado. Dr. Provencher’s story spans small-town roots, elite military service, academic medicine, professional sports, and entrepreneurial ventures. His journey offers physicians …
Lessons on leadership from a Navy surgeon and NFL doctor
In the fast-paced world of reproductive endocrinology and infertility (REI), even seasoned clinicians from other specialties can find themselves lost in the weeds of embryo reports. While most of us recall the basics of mitosis and meiosis from medical school, the clinical nuances of embryo morphology and grading are often not taught until fellowship.
Understanding these metrics is essential for informed decision-making. Whether you are an OB/GYN managing patient expectations or …
A clinician’s guide to embryo grading in IVF
I walked out of my physician’s office steady and clear in my decision to transfer my care. I didn’t accuse her of anything. I didn’t raise my voice. I simply informed her that I would be transitioning to another clinician within the same concierge program.
She immediately assumed I was leaving for financial reasons and suggested physicians to see outside the system. When I clarified that her administrator had already approved …
Why women’s symptoms are dismissed in medicine
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