Every week, I see patients not because they need to, but because their insurance company says they must. A patient came in recently for one reason only: Her insurer required a referral before she could see a specialist. She didn’t want to. I didn’t need her to. But we both had no choice. After a 20-minute visit neither of us needed, I did what the insurer required: document, click, submit. …
The patient was in her forties. She experienced chest pain, but it did not appear to be “classic.” Her ECG was normal. Her labs did not raise alarms. The team leaned toward anxiety. Hours later, she went into cardiac arrest from a heart attack. That silence after the code still stays with me. We anchored on the first test. We closed the case too early. We stopped listening to her …
Money management and career planning are considered life skills (but the skill that shapes health self-advocacy) deserves the same status. Without it, care suffers. My family member was recovering from surgery, facing medication safety concerns, severe anxiety, and the need for constant care. At the same time, I was managing my own records and preventive health. Like so many women, I had become the family’s chief health executive, carrying responsibilities …
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Internal medicine physician Sally Daganzo discusses her article “How functional medicine fills the gaps left by conventional care.” Sally explains how a systems-based, evidence-informed approach can uncover root causes of complex conditions …
At the recent ECTRIMS Congress in Barcelona, researchers presented data that should make every specialist pause. In a claims analysis of nearly 70,000 patients with multiple sclerosis (MS), 98 percent of infections were first detected not in neurology clinics, but in primary care and other non-neurology practices. Even “serious” infections requiring hospitalization were almost entirely picked up elsewhere. The message was clear: Specialists, by design, often miss the forest for …
“Do you know what it feels like, to know you could die at any moment?” His words linger in the air, heavy, long after the threat of violence has passed, long after our team has calmed him with words and soft gestures. It is not the first time a patient’s family member has swung at me, nor will it be the last. But it is the first time with a …
There’s a common belief that leadership requires a title after your name, an office on the top floor, and people looking to you for direction. But in medicine, leadership happens at every level.
Take me, for example. I’m an attending physician, whose role on the team is as a hospitalist. In the hierarchy of medicine, it’s easy to dismiss this role as “just a physician.”
Yet there’s nothing “just” about it when …
The pilgrimage of my dreams included a suitcase full of diapers, extra pants, and a quiet prayer for dignity. Italy has always been a dream destination for me. As a Catholic, I consider Rome the Holy City of my faith, and this year’s Jubilee motivated me to visit the four Holy Doors. I also love art and culture, and Italy is home to many historic sites and great works of …
It should be obvious by now, but somehow it is not: Physicians are not immune to the same emotions that govern human behavior everywhere else. We like to imagine that our white coats and years of training somehow grant us a protective immunity to fear, to shame, to the raw surge of emotion that can stop us in our tracks. The truth is, physicians and other medical professionals are just …
If you have grown up under the realities of western medicine, you likely have general grievances about the financial cost of care, the inconvenience of scheduling and attending appointments, and the long wait times at the emergency room or to see a specialist. As a medical student and an occasional patient, the majority of my experiences have been in this philosophy of health care where everyone is entitled to quality …
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Anesthesiologist and clinical mental health counselor Maire Daugharty discusses her article “How therapy helps uncover hidden patterns.” Maire explains how psychotherapy leverages the brain’s pattern-seeking nature to reveal implicit beliefs formed in …
Prostate cancer treatment is evolving, and focal therapy is gaining relevance as part of that change.
For decades, patients and their physicians have had limited options: whole-gland treatments like radical prostatectomy or radiation, or active surveillance. But what about the men who fall somewhere in between? What about those who need more than monitoring, yet want to avoid the significant side effects associated with whole-gland therapy?
That is where focal therapy enters …
I just spent a weekend doing absolutely nothing. Well, nothing memorable, anyway. The week before, I’d been on home call during an Epic upgrade. If you’ve lived through one of these updates, you know the chaos. In addition to the usual phone calls about echo results, arranging studies, and communicating with referring physicians, I was getting a constant stream of secure chat notifications updating me on the system’s progress. These …
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As artificial intelligence (AI) continues to gain traction in health care, its potential to improve patient outcomes, streamline workflows and reduce human error is becoming increasingly evident. Many health care leaders are embracing AI as a core part of their digital transformation strategies. In fact, a recent study in Health Affairs, which analyzed data from the American Hospital Association, found that sixty-five percent of U.S. hospitals used predictive AI …
When I first stepped onto a college campus, I was the first in my entire family to do so. Coming from a humble immigrant background, community college was my gateway. Like many community college students, I was nontraditional, new to the country, starting from scratch. This was my first exposure to the American educational system, and I was just trying to figure it out while working multiple jobs.
Eventually, I served …
To be honest, I never imagined myself treating A-list celebrities and professional athletes in Manhattan. As a young physician in Juárez, Mexico, I spent my earliest years working in community clinics and even pharmacies on the city’s impoverished peripheries. Back then, the idea of practicing at one of the most prestigious hospitals in the United States (let alone as a pain management specialist) was unthinkable. And yet, only a few …
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Clinical psychologist Annia Raja discusses her article “Why more physicians are quietly starting therapy.” Annia explains how growing numbers of physicians are turning to therapy—not because they are failing, but because they …
I was watching Michigan take on Nebraska the other Saturday when a popular sandwich chain dropped its latest ad: “Our new 500-calorie Fit Sandwich!” Catchy. Marketable. But let’s be honest, it’s mostly bread, a little processed meat, and not much else. Yes, it comes in under 500 calories, but so does half a sleeve of Oreos. Does that make Oreos “fit”? This is the oldest trick in nutrition marketing. We …
Suicide is the elephant in the room in medicine. We rarely speak about it openly, yet it remains a silent epidemic, among our patients, and tragically, among physicians themselves.
I first encountered this reality as a medical student in Tennessee in 2022. One of my earliest patients was not much younger than I was. Because we were close in age, I felt we …
In Season 1 of the Wealth Planning for the Modern Physician podcast, host David Mandell, JD, MBA, sat down with Dr. Desmond “Desi” McGuire, a respected ophthalmologist and founder of Retina Associates of Orange County. Their conversation traced Dr. McGuire’s path from childhood influences and early career choices to building a thriving practice and navigating the financial ups and downs of medical entrepreneurship. For physicians seeking guidance on balancing clinical …
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