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 …
A pilgrimage to Italy with prostate cancer
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 …
Are doctors’ emotions fueling the opioid crisis?
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 …
A medical student’s journey to Tanzania
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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 …
How therapy helps uncover hidden patterns that shape our lives [PODCAST]
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 …
Focal therapy for prostate cancer: a new option
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 …
The power of ordinary joy for physician well-being
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 …
Reinforcing trust in AI: a critical role for health tech leaders
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 …
Leadership is about pulling others up
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 …
The opioid crisis in wealthy zip codes
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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 …
Why more doctors are seeking therapy to sustain their careers and lives [PODCAST]
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 …
Why a 500-calorie meal isn’t always fit
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 …
A doctor’s promise after a patient’s suicide
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 …
Building a practice and avoiding business pitfalls
On my first week of onboarding as an attending, before I had seen a single patient, I met the boulder in a training room.
It arrived as a screenshot. The EHR instructor clicked into a demo chart and a cascade opened: quality gaps, refill requests, preventive care nudges, “smart” routing rules that promised efficiency and smelled faintly of delegation without authority. I had imagined the threshold to attendinghood as a clean …
The first week of an attending physician
Obesity affects one-third of the adult U.S. population, including physicians, and is estimated to cost $147 billion annually. How does the Body Mass Index (BMI) of the physician affect the relationship with patients and the care provided? According to a study in Obesity magazine, “Understanding physician body weight as a possible barrier to obesity care is critical given the important role physicians can play in helping patients manage or lose …
How physician obesity affects patient care
Two emergency physicians with similar training work at the same hospital. Both have twelve years of experience. Both are contracted to work 2,000 hours per year, see roughly twenty patients per shift, and supervise staff. One is a man, the other is a woman. The same work, the same training, the same conditions. Not the same salary: The woman earns about $21,000 less each year.
That is not a hypothetical. That …
Why women ER doctors earn $21,000 less than men
Oncology has long been described as a discipline ruled by biology. Tumor pathways, mutational signatures, margins, and survival curves dominate how we measure, categorize, and predict outcomes. We are taught early in training that tumor biology is king, and much of our decision-making revolves around this truth. Yet, after years of practicing surgical oncology in India, I have learned that biology alone rarely determines the fate of my patients. Culture …
When culture has the final word in cancer care
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Physical therapist and physician advocate Kim Downey, mental health counselor Nikolai Blinow, and family physician and physician coach Tonya Caylor discuss their article “Focusing on well-being versus wellness: What it means for …
Why shifting from wellness to well-being matters for physicians and patients [PODCAST]
I began my career as a nurse practitioner in primary care, where patient visits are often limited to 15 or 20 minutes to manage complex conditions like hypertension, diabetes, and COPD. What struck me was how often these medical issues came with a psychological overlay like depression, anxiety, panic attacks, and trauma. That shaped the course of treatment as much as lab results or medications. The pace of primary care …
A nurse practitioner on leaving the medical machine
In the ER, we ask, Was he wearing a seatbelt
Partly for the note, but partly so we can remove ourselves
From exploded flesh, splintered bones,
Not sure if we can save that eye.
Something in us says, that will not be me;
I take precautions. We live on,
On the strength of the stories we tell ourselves.
But in the ICU, when one of our own has come in,
After a well-informed try at smothering the spark,
There …
A poem for a physician in the ICU
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