As physicians, most of us do not need another Zoom webinar on burnout; we need open space.
Even at the earliest stages of training, we are made to feel that we cannot take a break. In a med school course I teach, I assigned a renewal activity with a short reflection. Some protested, but most expressed gratitude for an assigned pause.
Many admitted how afraid they felt to step away, to take …
The pause medicine never taught us to take
I remember a patient who sat silently, staring at the hospital ceiling. She had survived a sudden illness that left her body weak and her spirit shaken. No tests, medications, or procedures could touch the despair in her eyes. In that moment, I realized something fundamental: The physician’s presence itself can be the most potent form of care.
Medicine, at its best, is more than diagnosis or intervention. It is an …
The healing power of physician presence in modern medicine
Almost every day, a physician says to me some version of the same sentence.
It may sound like frustration about metrics. Or exhaustion. Or administrative opacity. But beneath it is something more elemental:
“I am grieving what I hoped medicine would be.”
When that sentence is spoken plainly, without defensiveness, something shifts.
The suffering moves from defect to meaning.
Grief, in existential thought, is not weakness. It is evidence of attachment. We grieve what we …
How naming grief can restore meaning in medical practice
Robert felt winded climbing stairs. At 76, he attributed his fatigue to age. He thought his heart medications needed adjusting. His cardiologist agreed, tweaking his blood pressure pills. Six months later, Robert collapsed. In the ER, doctors found his heart walls dangerously thickened, stiff as leather.
A simple nuclear scan revealed the truth: transthyretin amyloid cardiomyopathy, or ATTR-CM, a progressive disease where misfolded proteins infiltrate the heart. Had anyone suspected it …
ATTR-CM screening: the missing link in heart failure diagnosis
When I arrived at a regional military hospital, it was not a dispensary or a community clinic. It was the referral hospital for the northern tier missile and bomber bases, positioned just below the major medical centers. We were second tier, but the stakes were global.
Into that setting, I brought the medical home and a mini-developmental clinic. Through a program for exceptional family members, families from around the world found …
The honest broker in pediatrics: Building the medical home
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Board-certified pediatrician and certified coach Jessie Mahoney discusses her article “Why doctors must stop waiting and reclaim their lives.” Jessie explains how medical training conditions doctors to view endurance as a virtue …
Waiting for the system to change causes burnout [PODCAST]
Every major policy in medicine is supposed to rest on evidence. We track outcomes for new drugs, devices, and procedures. We measure hospital mortality, infection rates, and adherence to guidelines. Yet one of the most time-consuming and expensive physician policies of all, Maintenance of Certification (MOC), has never been held to that same standard.
For decades, the American Board of Internal Medicine (ABIM) and other specialty boards have argued that recertification …
MOC patient outcomes: Why recertification doesn’t guarantee quality
At 62, I unwittingly became a cliché: the physician who makes a poor patient.
The hard lump in my right breast, directly inferior to the nipple at the 6 o’clock position, shocked and shook me in the middle of a long August night when it first poked me as I tossed and turned my way through a bout of insomnia.
A screening mammogram for September 12 had been on my calendar for …
When the doctor becomes the patient: a breast cancer journey
Sarah, a new attending, has been asked to work with June, a PGY-1 resident who has struggled with new admissions.
On rounds, June recommends a urinalysis for a patient with advanced dementia and new agitation.
“Why a UA?” Sarah asks.
“Behavior changes can indicate a urinary tract infection in older adults,” June replies, confident and fluent.
Inside, Sarah splits. She wants to teach, to pause, invite uncertainty, and help June reason through delirium and …
Why medical education assessment kills curiosity in residents
In medical school, I’ve been taught to take chest pain seriously. If a patient presents with angina, there are clear guidelines, robust evidence, and standardized protocols to follow. Yet, when a patient comes into the clinic describing mood swings, fatigue, or pain tied to their menstrual cycle, the responses of clinicians are often vague, stating, “That’s normal.” Behind that simple phrase lies decades of neglect in how we study, fund, …
Menstrual health in medicine: Addressing the gender gap in care
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Physician, author, and health care reform advocate David K. Cundiff discusses his article “Accountable care cooperatives: a community-owned health care fix.” David outlines a transformative plan to replace the fragmented U.S. insurance …
Community ownership transforms the broken health care system [PODCAST]
I practice mobile wound care because it works. Treating chronic wounds in patients’ homes, skilled nursing facilities, and assisted living settings improves adherence, reduces missed visits, and often prevents avoidable hospitalizations. For medically complex patients, mobile wound care is not a convenience; it is frequently the only viable model.
But in 2026, mobile wound care is under sustained pressure. Lower local coverage determinations (LCDs), intensified CMS surveillance, and expanding documentation requirements …
Mobile wound care in 2026: Navigating regulatory pressures
In modern medicine, we like to believe that geography no longer determines outcomes. Advanced technology, integrated referral systems, and universal health coverage are supposed to ensure timely care for everyone. Yet for one woman in Taiwan, a country often praised for having one of the world’s most efficient universal health care systems, the greatest obstacle to cancer treatment was not distance. It was time.
Ms. Li, a retired woman living in …
Why smaller hospitals may be faster for cancer diagnosis
As reported in the Philadelphia Inquirer, Louis-Hunter Kean was 34 years old when he died in November 2023 at the Hospital of the University of Pennsylvania (HUP). For more than a year, he endured cyclical fevers as high as 104.5 F, drenching night sweats, profound fatigue, hepatosplenomegaly, cytopenias, and escalating inflammation. Over six months in 2023, he was hospitalized five times. His electronic medical record ballooned to …
Missed diagnosis visceral leishmaniasis: a tragedy of note bloat
I will never forget the patient I met in the emergency department who was pale, trembling, and in tears, her family in distress at her side in the trauma bay. She was suffering complications after taking medication to end her pregnancy. While such side effects can occur with medical abortions, they are markedly more likely when patients are forced to use misoprostol alone, a reality in states that restrict access …
Mifepristone restrictions: How bans force patients into riskier care
In Accra, Ghana, the ward glowed ocean blue under phototherapy lamps. Chlorhexidine lingered in the air, cardboard rustled beneath a mother’s thin blanket, and the soft gasp of a preterm infant punctuated the hum of monitors. A baby’s drool pooled at the corner of her mouth; when my gloved fingers brushed her cheek, she flinched. Her body spoke a language beyond words, and her mother translated every twitch with love.
Behind …
Pediatric care in Ghana: Addressing malnutrition and sickle cell disease
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Palliative care physician and certified physician development coach Christie Mulholland discusses her article “Why every physician needs a sabbatical (and how to take one).” Christie reveals the harsh reality that while sabbaticals …
Sabbaticals provide a critical lifeline for sustainable medical careers [PODCAST]
Modern medicine has a lot to show for all our breakthroughs and biotechnology. At an astonishingly rapid rate, we have built a health care system that can map the genome, replace a heart valve, and monitor vital signs from a wristwatch. All this to show that medicine’s success has always been measured in cures, and in that pursuit, we have forgotten to care. This is where medicine fails.
A cure is …
Curing versus caring in medicine: Bridging the gap in patient trust
The moment the text message lit up my watch, I knew my life had irrevocably changed. I looked down at the miniature screen and found that I could not look away from the gray bubble and the three words that shattered my world: My aunt had passed away. An all-consuming grief overtook me as I processed a reality where my aunt’s boisterous laugh no longer echoed off the walls, along …
Flexible health care funding: Moving beyond disease eradication
An excerpt from Physicians With Lived Experience: How Their Stories Offer Clinical Guidance (APA Publishing, 2025).
“Here is the truth: I have been on a stable dose of Wellbutrin (Bupropion) for thirteen years, and despite being quite a public advocate about self-disclosure and mental health, I have never once said that out loud. If you have ever read anything I’ve written before …
Why a chief wellness officer hid her medication use for 13 years
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