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This episode is sponsored by Oracle Health and Life Sciences.
Doctors have heard promises about health technology for decades. Now artificial intelligence has to …
Making AI work for physicians [PODCAST]
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She loved the job for 20 years. She left anyway. Christine King, certified registered nurse anesthetist, returns to explain what changed in the operating room and what it cost her. This episode is …
Why business pressure and threats ended a career she loved [PODCAST]
I’ve been a registered nurse for over eighteen years. I’ve held dying newborns, guided families through their loved one’s final days, and summoned hospital chaplains to honor last wishes and sit with families in their worst moments. In the controlled chaos of a hospital, health care workers know their roles, and there’s a crash cart three steps away. Death, in a clinical sense, is something that I know.
Or so I …
Why witnessing death outside the hospital felt different
I had a patient come in recently to discuss readings from her continuous glucose monitor. She was not diabetic and had no specific symptoms, but had purchased the direct-to-consumer device in the interest of obtaining more data about her health. The device had carefully captured her data and did periodically flag readings outside of the normal range. She had then run these reports through an AI chatbot, which, she explained …
Automation bias in health care can become paternalism
American medicine has a peculiar definition of generosity. We will spend enormous sums treating a seriously ill older person: an ambulance, an emergency-room visit, scans, intravenous medications, surgery, and days in hospital. We may then pay to send a profoundly frail patient to a skilled-nursing facility for “rehabilitation.”
But suppose what that patient really needs is someone to help her out of bed, make breakfast, and keep her safe at home. …
Medicare home care coverage pays for rehab, not an aide
On September 16, Senators Warren, Wyden, and Merkley, with Representatives Ocasio-Cortez, Hoyle, and Subramanyam, introduced the Stop Corporate Takeovers of Physicians Act. Modeled on an Oregon law that took effect this year, it would bar private equity funds, insurers, and other for-profit corporations from owning or controlling medical practices, close the friendly-physician loophole, and limit restrictive covenants. Most physicians will like most of what is in it. I do.
But the …
Private equity in medicine did not kill private practice
For years, I thought good doctors always said yes.
Can you squeeze in one more patient? Yes. Can you answer this message before you leave? Of course. Can you finish this chart tonight? Yes. Can you take care of just one more thing? Absolutely.
It rarely felt like a major decision. Each request seemed small. A few more minutes. One more patient. One more message. But small yeses have a way of …
Setting boundaries as a physician doesn’t mean caring less
A solution to the typical afternoon sinking spell is short bursts of exercise. In this blog, I will discuss the concept of short bursts of exercise and how just 1 to 2 minutes of cardio exercise that won’t make you break out in a sweat will make you more productive and less lethargic.
The evidence continues to grow that even short periods of activity can make a difference. A recent …
Short bursts of exercise can ease the afternoon slump
Adapted from The New Eugenics in Medicine: Two Novellas About Power, Science, and the Future of Human Worth.
The Netherlands’ first reported termination of life in a child between ages 1 and 12 under its 2024 framework for regulating pediatric euthanasia has become a global lightning rod for debate over the merits and sins of euthanasia.
A Dutch child was almost 2 years old and had been born at 26 …
Pediatric euthanasia and the fear of a new eugenics
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Many doctors picture themselves practicing until the day they die. Andrea Hayes decided otherwise, and tells you what came next. She is a retired endocrinologist, author, and speaker. This episode is based on …
Retirement isn’t the end of medicine, it’s a second act [PODCAST]
Cannabis use disorder (CUD) and cannabis withdrawal syndrome (CWS) have been recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) for more than a decade. Researchers have documented symptoms of anxiety, irritability, insomnia, depression, decreased appetite, intense cravings, physical symptoms, and more. Despite years of published evidence, cannabis use disorder remains one of the most underrecognized and under-resourced substance use disorders in health care. The latest findings from …
Why cannabis use disorder and withdrawal go unnoticed
As I draped the ultrasound table and laid out the sterile speculum, I noticed my patient’s shoulders were locked near her ears. Her chart noted a history of failed fertility cycles, but her vitals on the intake sheet were perfectly normal.
It would have been easy to finish setting up the tray, check the box, and fetch the physician. Instead, I paused and asked, “How are you holding up today?”
She exhaled …
What clinical support staff notice that charts never show
Only 33 percent of patients who use herbs or supplements disclose their use to health care providers, often viewing them as natural and therefore harmless. Targeted history-taking is the ultimate line of defense for ruling in or out herbal/dietary supplement-induced liver injury (HILI) and broader supplement toxicity, including herb-drug interactions.
Clinicians must look beyond standard prescription lists and systematically audit everything a patient ingests. Asking a few high-yield questions …
How to diagnose supplement toxicity in 4 clinical steps
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For more than two decades, I have practiced emergency medicine. The job trains you to recognize patterns quickly because sometimes the pattern is the difference between sending someone home and recognizing a catastrophe that is still assembling itself.
A heart attack arrives after years of vascular disease and suddenly becomes an emergency. A stroke may represent decades of biology revealed in minutes. Sepsis can turn a functioning immune system into something …
Chronic inflammation and immune aging may share mechanisms
A 30-year-old man with obesity and longstanding type 2 diabetes comes in for a routine follow-up. His glycemic control remains poor despite treatment. As the visit unfolds, his physician notices persistent adult-onset acne. Years ago, the encounter might have ended there. Today, I imagine asking another question: “Does anyone in your family have what we used to call polycystic ovary syndrome?” His sister does.
That answer does not diagnose him with …
Family history of PCOS can reshape metabolic care
Ask most physicians outside emergency medicine how they’d handle a patient presenting with three possible diagnoses, incomplete labs, and a deteriorating vital sign trend, and you’ll usually get a version of “I’d want more information first.” Ask an ER physician the same question, and you’ll get an action plan within seconds. That gap isn’t intelligence. It’s training. And I think it’s worth naming exactly what that training builds, because most …
How emergency medicine decision making works under pressure
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A pediatrician gave a child vaccines the chart said he needed. The record showing he had already had them was buried in the system. Dennis Hursh is a health law attorney and founder …
Blaming the doctor is cheaper than fixing the record system [PODCAST]
It was the month of February; there was a different excitement and joy in my family as we were planning my little brother’s Bratabanda. It was special not only because we had a special occasion but also because it was the very first function organized by my family. On the Bratabanda day, we were all very busy, and the party was about to end; my father’s school friend group joined. …
Learning empathy in medical school took my father’s cancer
The author and his wife, at a time when getting off the floor required considerably less planning.
People ask what being an emergency physician is like, and they expect the blood, the saves, the codes, the worst nights. Those happen, and they matter, but I try not to carry those home. What I try to keep is the people. You meet everyone in …
Why I stay in emergency medicine: a dancer at nearly 100
A patient arrives for surgery after weeks of waiting. They have fasted, taken time off work, arranged transport, and prepared themselves mentally for the operation. Then the anesthesiologist says, “I think we should wait.”
For the patient, this can be frustrating. “I feel fine.” “Why can’t we just go ahead?” These are understandable questions. But one of the less visible parts of an anesthesiologist’s job is deciding not only how to …
What being cleared for surgery does not actually mean
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