When I arrived in the U.S. as a young physician in the early first week, I didn’t know what “passed out” meant. Or “threw up.” My English was polished—British-style, courtesy of Indian schooling—but I wasn’t prepared for American slang, accents, or sports metaphors. So there I was in a Philadelphia hospital, fumbling through a patient history. I was embarrassed—by my accent, my vocabulary, my uncertainty. But I wasn’t humiliated. That …
You, there beyond the words of this page. Oh, how I wish I could step beyond this limited medium and have a one-on-one conversation with you, as this matter is of the utmost importance to me. Unfortunately, I can do no such thing. As a result, I must lay out the groundwork by which this spewing of feelings will work henceforth. We medical students are fond of only wasting our …
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Board-certified nurse practitioner Shabeena Hirani discusses her article “From nurse practitioner to quality improvement leader in sleep medicine,” sharing her journey from clinical care to driving systemic change. Shabeena explains how her …
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Nearly one in three U.S. physicians report having been sued, and in some specialties, a malpractice claim is almost inevitable. When a clinical decision becomes the subject of a lawsuit, it can feel like an attack on your integrity and identity. Having the right support during this time can make all the difference. Litigation support …
For the last several years, burnout (a syndrome typically defined as emotional exhaustion, cynicism, and poor efficacy) has been a hot topic in the world of health care. But as a bit of good news, the AMA recently released that the rates of physician burnout are at the lowest they have been since the beginning of the COVID-19 pandemic. However, I would argue that if 43 percent …
As a board-certified neurologist in independent practice for three decades, I’ve watched the soul of medicine slowly erode, not due to a lack of compassion, skill, or science, but from a suffocating bureaucracy that has infiltrated every corner of patient care. Private practice doctors across America are being regulated, pre-certified, audited, and administratively strangled out of existence.
Each week in my office, my staff and I spend countless hours fighting with …
It is Saturday, late in July and hot as blazes in Louisville, Kentucky where I live. I’ve been here for many years.
I sit in a McDonald’s restaurant close to my home. The place is just about empty. I am here after a short walk from my house, about half a mile. I am happy to be here—happy, that is, that I can manage to walk this far, even in the …
An excerpt from The Fix Your Internal Language Handbook.
“I talk to myself, and I talk to them. They are not here to listen to me.”
Most of us spend more time talking to ourselves than to anyone else. We use language to think and clarify our thoughts. Whether we are consciously ruminating or thinking on a more subconscious level, we are still using language. We have internal dialogues with ourselves, …
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Health care executive Shelli Pavone discusses her article “Why retail pharmacies are the future of diverse clinical trials,” highlighting the urgent need to improve representation in clinical research. Shelli explains how barriers …
A busy waiting room with buzzing lights, cramped-up chairs, and rushed medical staff on the clock can make you feel more anxious about the care you are going to get. Clinic waiting rooms are often the first point of contact between patients and health care providers.
The psychology of waiting
While traditionally considered functional spaces, a growing body of evidence suggests that the design and ambiance of these environments significantly influence patients’ …
“What is your favorite homemade food?” I ask each patient. Almost always, there is a smile, and the conversation takes off from there. Moms light up describing their special dishes. Patients giggle when I suggest, “Should we have your mom make some for us to share?” Younger kids look at their moms with wide eyes, wondering if it could really happen. Those moments, those faces, are priceless; and they carry …
Previously, I wrote about politicians regulating medical practice. I support regulations that protect individual or public health. However, when these laws are not evidence-based, misguided or frivolous, and potentially harmful, as occurred when 16 state legislatures permitted over-the-counter sale of ivermectin, they are unacceptable.
There have been instances when pregnant women, who, because of circumstances, were unable to adhere to physician advice for increased bed rest to avoid premature labor, were …
In the heart of major cities—from New York to Nairobi, Mumbai to Mexico City—medical professionals are confronting more than fevers, injuries, or chronic illness. Increasingly, they face diseases rooted in environmental exposure. From asthma linked to air pollution to cancers tied to industrial toxins, physicians are witnessing firsthand the impact of environmental degradation on human health. For many, this reality transforms them from caregivers into advocates—environmental activists in white coats.
Doctors …
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Osteopathic medical student Scarlett Saitta discusses her article “Integrating vitamin education in mental health care,” highlighting the growing evidence that nutritional deficiencies can profoundly impact psychiatric outcomes. Scarlett explains how deficiencies in …
A few months ago, I met a woman who had stopped speaking at dialysis. She had grown quiet, worn thin by the rhythm of a system that seemed to talk around her but never truly to her. When she finally spoke to me, it was not about her labs or transplant status. It was a whisper — “Do you think I’ll make it in time?”
In that moment, she wasn’t asking …
When I was a child, I watched a neighbor struggle after a stroke. He survived, but without rehabilitation he remained trapped in his disability, dependent on others for every task. That memory shaped my understanding of medicine: Survival alone is not enough. Patients deserve a chance to reclaim independence and dignity.
Years later, after completing medical training abroad, I came to the United States as an international medical graduate (IMG), determined …
Introduction
When I first arrived in North Carolina several years ago, I thought happiness would come easily. I had completed my medical education in Nepal, was ready to serve as a physician in the U.S. health care system, and carried the excitement of new beginnings. But I learned that happiness is not automatic—especially for physicians navigating American health care while maintaining their sense of purpose.
The transition from practicing medicine in Nepal …
Before making the case for evolving formal fellowships for physician anesthesiologists to conscientiously and systematically object to unnecessary health care, particularly unnecessary procedures, it is worth first exploring what constitutes “necessary.” Only then can we begin to regulate what may be considered “unnecessary.” Can physician anesthesiologists lead such academic and practical regulatory efforts, even amid potential conflicts of interest inherent in their role as anesthesia care providers?
This raises several important …
Recently, The Hill published an op-ed purporting to be a measured critique of gender-affirming care for youth. In reality, it was a dangerous and misinformed piece of ideological propaganda cloaked in the language of academic concern and propped up by debunked claims and bad faith arguments.
Riffer, who has studied censorship, gender regulation, and the legislative targeting of LGBTQIA+ communities across the U.S., will say …
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Physician Daryna Bahriy discusses her article “How Ukrainian doctors kept diabetes care alive during the war,” sharing how medical teams in western Ukraine adapted to protect vulnerable patients amid the chaos of …
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