For those who know me personally, you know that I have vitiligo. Vitiligo is an autoimmune disease affecting the skin, where there are patches of depigmentation (the skin appears white or pink). It is sometimes associated with other medical conditions.
I met someone recently and they said that they were curious about my skin. I am used to looks or questions and am happy to educate people about vitiligo, so I …
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Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “How deprescribing in psychiatry offers a path to safer care.” Muhamad explores the growing movement to reduce unnecessary …
Conventionally, medical malpractice is argued using inductive reasoning. There is nothing wrong with inductive reasoning. It is a component of critical thinking. However, it is just a component. Inductive reasoning is more subjective than objective and the influences of selection bias, avoidance bias, and confirmation bias are undetectable.
Deductive reasoning is also a component of critical thinking. It is not immune from these same biases; however, deductive reasoning is more robust …
I am not a doctor. I am a software developer who taught herself mobile development while working full-time and raising two kids. But I built a clinical simulation app used by medical students, and here is how I made sure it is actually clinically sound.
The credibility problem
When you don’t have an MD, you can’t rely on intuition or clinical experience. Every design decision has to be defensible, referenced, and auditable. …
When clinicians think about stroke recovery, attention often focuses on motor deficits, speech impairment, and the risk of recurrent cerebrovascular events. Cognitive outcomes, however, are frequently treated as secondary or inevitable consequences rather than primary targets of intervention. This oversight carries consequences. Post-stroke cognitive impairment (PSCI) is common, persistent, and one of the strongest predictors of long-term disability, institutionalization, and caregiver burden, yet it remains under-recognized in routine care.
As acute …
The years pass without ceremony.
They do not always announce themselves.
Sometimes they slip by like quiet weather,
like afternoons we cannot later recall
except by the way the light
once rested against a wall.
Time moves like autumn wind,
unannounced,
persistent,
tender in its own indifferent way.
A milkweed stands in a field,
having grown tall without noticing
the exact moment it became mature.
Its green has deepened,
its stem stiffened with understanding.
Now the wind arrives,
and the pods open
not in grief,
but in readiness.
Each …
“I don’t know” may be one of the most difficult phrases to both hear and admit. As a patient, fewer words can make you more anxious, and as a health care provider, fewer words can make you feel more powerless. As a whole, the medical community has fostered and embraced a culture of certainty, discouraging the phrase “I don’t know” because of the helplessness it can instill in patients and …
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Palliative care physician and certified physician development coach Christie Mulholland discusses her article “5 things health care must stop doing to improve physician well-being.” Christie challenges the pervasive narrative that younger physicians …
During the COVID-19 pandemic, conversations about burnout and stress exploded, particularly among health care workers. Much of the advice centered on self-care practices: taking time off, scheduling massages and spa days, practicing mindfulness, protecting your evenings, using your PTO. While these strategies are valuable, they are not the full story.
Positioning self-care as the solution to stress oversimplifies a much deeper physiological process. For many patients (and clinicians) stress is not …
Based on our combined experience of over 70 years in patient advocacy, pain management, and behavioral neurology, we are convinced that U.S. public perception and public policy on treatment of pain have been driven almost entirely by sociopolitical and legal factors. Seldom in recent years has policy been significantly influenced by science.
The U.S. enjoyed a brief period of scientifically enlightened policy in the late 1990s through 2008. A large number …
Emergency medicine trains clinicians to recognize patterns early, anticipate deterioration, and intervene before outcomes become irreversible. We pride ourselves on seeing what others miss. Yet we are repeatedly instructed, explicitly or implicitly, to ignore the largest pattern of all. Political decisions consistently and predictably shape who arrives in our emergency departments, how sick they are, and how unsafe the environment becomes for the people expected to care for them.
If political …
In recent years, medicine has become more open about burnout, workforce shortages, and the challenges facing women in health care leadership. We write about mentorship programs, leadership pipelines, and the need to bring more women into ownership and executive roles. We celebrate women who build clinics, lead departments, and create space for others to rise.
What we talk about far less is what happens when women actually meet each other in …
In an increasingly digital world, older adults are often viewed as prime targets for financial scams. These malicious schemes exploit vulnerabilities inherent in aging, such as social isolation, cognitive decline, and trustfulness. As primary care physicians, we are in a unique position to recognize the signs of vulnerability in our older patients. Understanding the methods employed by fraudsters, the impact on victims, and how to educate them on preventative measures …
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I have the great honor and privilege of coaching medical students throughout their training. In the past week, several students have shared experiences that have stayed with me: On clinical rotations, some shared stories of being referred to only as “student one” or “student two,” their humanity quietly erased. Others described managing food and housing insecurity while carrying the financial burden of medical education. Still others, particularly students with darker …
The false promise of efficiency
The latest punditry calls for three-year medical schools, stripped of ethics and other vital subjects, with less clinical training. The rationale? Efficiency. The result? A generation of physicians unprepared for the complexity of children’s lives.
General pediatricians themselves admit in published surveys that they “know squat” about developmental-behavioral pediatrics (DBP) after residency. Yet the proposed solution is to shorten training further. That is not reform; it is …
The story of gastroenterology in 2025 is no longer about productivity or reimbursement, it’s about manpower. Hospitals and practices across the U.S. are struggling to recruit, retain, or even temporarily staff the specialists who manage digestive diseases, perform colon cancer screening, and handle emergency procedures like ERCP. What we’re facing isn’t simply a staffing issue; it’s a structural shortage decades in the making.
The shrinking pipeline of gastroenterologists
In the mid-1990s, roughly …
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Physician, former health care executive, certified coach, speaker, and organizational consultant Laura Suttin discusses her article “Why the 4 a.m. wake-up call isn’t for everyone.” Laura shares her personal struggle with the …
Medical education has a blind spot.
We spend years teaching students to identify diseases. We drill them on symptoms, pathophysiology, and treatment algorithms. By the time they reach clinical rotations, most can rattle off the differential diagnosis for chest pain or abdominal discomfort without hesitation.
But ask a third-year student how much a CT scan costs, or whether an MRI is worth the added expense over an ultrasound, and you’ll often get …
More physicians than ever are reaching out for support after being labeled disruptive, inefficient, delinquent, reactive, or poor communicators.
These are highly skilled, deeply committed professionals being written up for professionalism concerns, communication issues, behavior, and “reactivity.” These cases span every specialty, gender, and stage of career.
This is not a reflection of declining professionalism. It is a predictable outcome of practicing in an untenable and broken system. It is an expected …
I used to think medicine would change me by adding things. Knowledge. Confidence. Authority. Certainty. I assumed growth would look like accumulation, more skills, more answers, more control. What actually happened was the opposite. Medicine changed me by subtraction.
When I started writing as a medical student, everything felt sharp and exposed. The hospital was loud, inefficient, and often cruel in ways no one named out loud. I wrote about scut …
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