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Psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “Physician suicide prevention: a call to action.” Muhamad opens with the tragic losses of Dr. Nolan R. Williams and Dr. …
Physician suicide represents a silent epidemic demanding urgent reform [PODCAST]
One of the marks of a good physician is the ability to approach illness from two complementary angles. We bring scientific knowledge, training, and objectivity to understand what is happening in the body. But the work doesn’t end there. What truly elevates a clinician is the willingness to honor how the patient experiences their illness, the internal narrative that no lab test can measure.
This dual lens is not unique to …
How neurodiversity in relationships shapes communication
When my father-in-law died by suicide, our family did not just lose a person. We lost the gravitational center of a small universe.
He was a giant in my eyes. Not because of his curriculum vitae, though his was extraordinary, but because of the way he moved through the world: steady, modest, and relentlessly devoted to the people who needed him.
He had survived what should have broken a human being. As …
Physician suicide: a daughter-in-law’s story of loss and grief
“Doc, can you prescribe me some BPC-157 with sermorelin, and maybe semaglutide too?”
He didn’t come in asking about his sleep.
He didn’t mention that his last meal the night before was at 11:30 p.m., eaten in front of a laptop glowing with unanswered emails.
He didn’t bring up the statin he’d been taking for years, the creeping fatigue he’d started to normalize, or the way his waistline had slowly expanded as his …
Why lifestyle matters more than BPC-157 and semaglutide
Most recognize me from posts about deductive reasoning on KevinMD, but I never explain deductive reasoning’s effect on a conventional medical malpractice lawsuit. Here is how it affects such a lawsuit.
All medical malpractice lawsuits have four things in common:
How deductive reasoning changes medical malpractice lawsuits
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Professor and senior associate dean of engagement Janet A. Jokela discusses her article “Reflecting on the significance of World AIDS Day from the 1980s to now.” Janet shares harrowing memories from her …
Personal memories reveal the transformation of HIV care over four decades [PODCAST]
It doesn’t take much to understand that women have had it tough throughout history. While seemingly in our age there is near parity (with many women heads of state in Mexico, Italy, Moldova, Iceland, etc.), they only gained the right to vote in the U.S. 105 years ago (with the 19th Amendment to the Constitution), which was 50 years after Black men in 1870 (the 15th Amendment). There have always …
How blaming women for a baby’s sex persisted through history
In hospital boardrooms across America, the “30-day readmission rate” is treated as a financial vital sign. It determines reimbursement levels under the Hospital Readmissions Reduction Program (HRRP); it influences star ratings; and increasingly, under new Department of Justice scrutiny, it serves as a barometer for potential “substandard care” investigations.
Yet, despite decades of regulation and millions spent on discharge planning software, the needle on preventable readmissions barely moves.
The industry is failing …
The “patient carryover crisis”: Why hospital readmissions persist
The room went quiet the way rooms do before something consequential, when conversation thins and all you can hear is the pulse in your ears.
“Captain Kumar,” the instructor said, “you have an in-flight engine failure. What do you do?”
I stood at attention, spine locked, as my classmates turned toward me with the focused expectation of a clinical team evaluating a tenuous presentation. A bead of sweat slid down my temple. …
How flight surgeon training mirrors medical residency stress
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Health care strategist Dana Y. Lujan discusses her article “Is direct primary care sustainable in a downturn?” Dana explains how the rising cost of living and subscription fatigue are challenging the retail …
Economic reality tests the limits of subscription medicine [PODCAST]
On December 5, I started my hospital shift learning that the ACIP (Advisory Committee on Immunization Practices) had voted against offering universal administration of hepatitis B vaccine at birth, opposing the long-standing practice endorsed by experts. After a long day of examining newborn babies and counseling families, my mind drifted back to the announcement and unearthed a memory of a boy named Sam.
Sam was born a healthy newborn to loving …
Why ACIP’s ruling on universal hepatitis B vaccination endangers newborns
I have spent my career practicing medicine in the real world: caring for patients, managing uncertainty, and making decisions where the stakes are personal and immediate. In recent years, I have also spent considerable time designing and deploying medical software that uses artificial intelligence in live clinical environments. Together, these experiences have reshaped how I think about the future of our profession.
That combination of experiences has led me to a …
AI in medicine: Why it won’t replace doctors but will redefine them
Last week, I spent over two hours on a prior authorization for a patient who needed a medication she’d been stable on for years. Two hours of hold music, transferred calls, and faxed forms, while patients waited.
That same week, Anthropic announced Claude for Healthcare: An AI system that can verify coverage requirements, build claims appeals, and streamline prior authorizations in minutes. OpenAI launched ChatGPT Health days earlier. Both promise to …
Claude for Healthcare vs. administrative burden: a physician’s review
I come from a long line of physicians. My grandfather was a pioneer in pharmacy and biochemistry, so influential that a museum now bears his name. My father, also a doctor, was cut from a very different cloth. I have written before about our strained relationship and the heavy expectations placed on a child born into a family with a reputation to uphold. Those tensions shaped my early views …
The burden of being both doctor and family: an ethical reflection
I proudly bear the title of “Dad,” and my daughter is five (going on 15), fiery, carefree, and unmistakably precocious, yet still my silly, innocent, sweet little girl. I imagine many girls with older brothers develop a similarly spirited personality. However, with her brothers being slightly older, I’ve watched that same innocence gradually diminish in them, as they are being slowly exposed to life’s complexities through school, friends, and their …
A physician father on the Dobbs decision and reproductive rights
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Otolaryngologist Alan P. Feren and patient advocate Joyce Griggs discuss their article “Why health self-advocacy is an essential life skill.” Alan and Joyce share the personal journey of becoming a “chief health executive” …
Navigating the medical system requires specific life skills [PODCAST]
School had just started for the new school year. It was hot and humid. I had just retired from ICU nursing and behavioral health, a 46-year career and never skipping a beat. After several months of retirement, I couldn’t sit still. I was bored and had that nagging feeling that I wasn’t done yet with my career. Maybe that nagging feeling was guilt. Like you can’t quit. You can’t stop. …
A school nurse’s story of trauma and nurse burnout
There are many ways to say “no” in medicine.
“No, this antibiotic won’t help a viral infection.”
“No, this test won’t change our management.”
“No, that surgery carries more risk than benefit.”
And then there is the newest way:
“No, the algorithm doesn’t prioritize your health.”
Welcome to WISeR, short for “Wasteful and Inappropriate Service Reduction,” a Medicare pilot program that promises to usher artificial intelligence into health care decision-making with all the subtlety of …
WISeR Medicare pilot: the new “AI death panel”?
For years we have told patients the same thing when they have trouble finding a doctor: Go to your insurance directory, look it up, they can help you.
And despite saying that, many of us have quietly known for a long time that this advice is broken. We still give it. We give it hoping for the best, knowing there really are not many other useful options to offer at this …
Ghost networks in health care: Why physicians are suing insurers
There is a dangerous assumption circulating in skilled nursing facility (SNF) boardrooms: “If it’s documented in the EMR, we are protected.”
For years, this logic held up. Compliance was a game of checkboxes. Did the nurse educate the patient? Check. Did the patient verbalize understanding? Check. Is the care plan signed? Check.
But the regulatory landscape has shifted beneath our feet. The Department of Justice (DOJ) and CMS are no longer just …
SNF discharge planning: Why documentation is no longer enough
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