Mrs. C is 80, frail, with heart failure and early dementia. The team has begun discussing an ICD. Her daughter wants “everything done.” The resident knows the evidence cold; he can recite the trial data, the ACC recommendations, and the mortality benefit. But he’s frozen at the bedside.
The gap we don’t talk about
Modern medical education does one thing brilliantly: It transmits knowledge. Today’s residents master more pathophysiology, more evidence, and …
In inpatient psychiatry, teams often face a familiar problem: The clinicians at the bedside see ongoing risk that warrants hospital-level care, while the payer’s reviewer concludes the stay is no longer “medically necessary.” The result can be frustration, rushed discharges, or days spent on the phone. Behind the scenes, costs mount; measured not just in dollars, but in readmissions, emergency department boarding, and clinician burnout. Physician advisors help resolve this …
The Bay Area has become the epicenter of artificial intelligence, home to renowned startups and labs racing to prove AI’s power to transform our daily lives.
Just three months ago, California released its own Frontier AI Policy Report, commissioned by Governor Gavin Newsom, which warned that without stronger oversight and transparency, AI models threaten equity and accountability, especially in health care. Nowhere is this danger more urgent than in dermatology.
A …
Is your baby’s safe sleep a privilege?
In my Bronx clinic, I often sit across from new families who are well-versed in the American Academy of Pediatrics’ (AAP) safe sleep guidelines. Babies should sleep alone, on their backs, in a crib free of soft bedding and toys. Yet despite this knowledge, many parents, especially those who choose to exclusively breastfeed, face real-life barriers in following these recommendations. For single mothers and …
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Kidney transplant recipient Charlie Cloninger and nephrologist Nauman Shahid discuss their article “How early care saved my life from silent kidney disease.” Charlie shares his personal story of being diagnosed with kidney …
John, a man in his early sixties, waited nine months to see me about memory problems. When he finally arrived, I had twenty minutes. Eighteen went to detective work, extracting fragments of history from conflicting accounts, piecing together months of decline from unreliable memories, and completing a paper-based subjective memory test. What should have been a full consultation of patient-focused care, was reduced to only a few hurried minutes at …
This summer, my Facebook account was permanently “disabled.”
I had been helping another mother navigate a medical decision for her child, a young adult who is living with a degenerative condition. It wasn’t medical advice. It was empathy, drawn from my own lived experience as a medical mother, a certified coach, and years of teaching courageous communication at a medical school.
Meta AI had flagged the conversation as a violation of Community …
As a physician, you are no stranger to complexity. From the first days of medical school to the years of long shifts in residency, you make high-stakes decisions every day. Yet many doctors tell us they feel too busy, or under-resourced, to give their money the same level of care.
That is where a Personal CFO helps. Just as a hospital relies on a chief financial officer to align budgets, risks, …
Not long ago, a patient came to my busy clinic holding her phone. She had recently watched one of my short educational videos on heart attack warning signs, in Bengali. She told me, “Doctor, I did not know women can have different symptoms than men. That is why I came in today.”
That heartfelt conversation might have truly saved her life. And it was made possible not inside a hospital, but …
As a urologist, I consider myself an expert on the subject of prostate cancer. Here is a urologist’s view of a hypothetical announcement from a former U.S. president, five months after leaving office, of widespread high-grade metastatic prostate cancer.
Prostate cancer is the most common cancer in males. It begins as a cancer in the prostate, and with progression, metastatic disease occurs, primarily in the axial skeleton. Prostate cancer is known …
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Psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “It’s time to operationalize physician wellness.” Muhamad explains why wellness cannot remain a slogan or a poster …
I thought of this while watching the Cincinnati Open tennis today. Between games, a sports drink ad flashed on screen claiming it “hydrates better than water.” The players kept chugging neon bottles, and the announcer repeated the tagline like gospel.
That is when it hit me: For recovery, I would still reach for milk.
Hydration is more than water replacement.
Hydration is not just about replacing fluids; it is about keeping them in …
I can sit with patients and families and talk about hospice, dementia, or end-of-life care without hesitation. Years of training as a physician and geriatric psychiatrist have prepared me for those conversations. But when my own parent needed care, all that training suddenly felt useless.
Medical knowledge didn’t shield me from fear or guilt. It didn’t stop the second-guessing that came with every decision. It didn’t help me navigate the family …
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I was not just a contributor. I was the pediatrician in the room, the one who translated clinical reality into research clarity, even when the system preferred abstraction.
From 1997 to 2003, I lived a six-year burst of energy: equal parts clinical invention, research precision, and institutional resistance. It was my Trinity Site: a catalytic moment where everything fused: rural care delivery, editorial rigor, and systems reform. The fallout still shapes …
A demographic shift in viewership
With the rise of streaming, one platform is surging to prominence. According to Nielsen’s March 2025 report, YouTube now commands the highest total TV usage share of any media company at 11.6 percent. This marks a 53 percent increase in viewership compared to two years ago. But it is not because of younger generations sensationalized “addiction” with phones. It is a surge driven largely by …
The idea that medicine is a “calling” has been entwined deeply within our profession. From white coat ceremonies to recruitment posters featuring smiling doctors holding stethoscopes, we are told that to enter medicine is to answer a higher purpose. This framing is powerful. It inspires loyalty, fuels commitment, and builds identity. That is how the brainwashing begins as it also hides a dangerous truth: Labeling medicine as a calling has …
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Licensed counselor and coach Mary Remón discusses her article “A mindset shift for physicians: Retrain your brain to see what’s going well.” Mary explains how physicians are trained to scan constantly for …
The alarming relationship between artificial intelligence and adolescent body dysmorphia
That is what the American Health Law Association called the global increase in social media usage: an epidemic.
Indeed, social media usage and reliance, especially by youth, is becoming a mental health phenomenon quickly escalating out of control.
Nearly 25 percent of youth report spending over four hours on social media daily, with 46 percent of adolescents claiming that social media …
As a parent and a doctor of nearly four decades, I’ve often found myself navigating the rugged terrain of a dual existence: the life of a devoted physician, and the life of a dedicated parent. I have not always succeeded in both arenas. My wife and I both bear the weight of our professions, drawn into the noble yet demanding world of medicine. Our missions and ambitions, while fulfilling, have …
In the quiet that follows a routine pediatric check-up, a single word, “vaccines,” can suddenly change the air. Where vaccines were once a simple part of childhood, they have become something parents scrutinize, debate, and sometimes outright resist. The shift is palpable, and it is increasingly showing up in clinic rooms every day.
As a medical student training in New York City, I am constantly struck by a paradox: We live …
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