She clutched her chest, gasping for words that would not come in English. The nurse leaned in, trying to decipher. Her son was not there to translate, and the phone interpreter line was not connected yet. I could see her distress worsening. Precious minutes slipped away before we finally realized she was describing classic heart attack symptoms. That patient survived, but the outcome could easily have been different. And in …
When we began medical school, we had dreams and plans for what the next four years would look like. After all, we had the privilege of being siblings on the same medical training journey. The truth we have realized over these past years is that nothing truly prepares you for how medical school will change your time, priorities, and even your sense of self. Therefore, the decisions you make (or …
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Health care data strategist Lee Ann McWhorter discusses her article “Why health care reform must start with ending monopolies.” Lee Ann explains how monopolistic control by entities like GPOs, PBMs, EHR vendors, …
Prologue: the lost opportunity
Everyone knows Viagra as the “little blue pill” that revolutionized the bedroom. But what if its greatest potential was never about sex, but about saving lives?
A long-term study from Manchester followed men with both diabetes and a prior heart attack, about as high-risk a group as you can imagine. The results were astonishing: those who used sildenafil (Viagra) had a thirty-eight percent lower risk of another …
From daycare to college, the back-to-school season almost always correlates to one thing: a rise in respiratory illnesses. In late summer, when children are returning to their classrooms, outbreaks of illnesses like strep throat, influenza, COVID-19 and respiratory syncytial virus (RSV) become more common, and schools can quickly become amplifiers of community transmission. These infections can spread rapidly through contact with surfaces where the virus or bacteria is present, like …
Were you the one who always held it together? The responsible one? The one who made sure everyone else was okay, sometimes at the cost of your own well-being?
For most eldest daughters, this role is inevitable. We don’t choose it. We are handed it, early and often, because we are so “capable.” We accept this role and excel at it. That’s what most eldest daughters do with whatever is handed …
Understanding the legal process in America is not easy, and I do not envy the attorneys who try to defend doctors in court. I do envy them for their protections. Lawyers, for the most part, as elected members of Congress, create our laws. Others, also for the most part lawyers, are selected to be U.S. Attorneys, and they enforce those laws. Lawyers called judges control our courtrooms. Almost all of …
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Surgeon Fateh Entabi discusses his article “A surgeon’s take on God, intelligence, and cosmic responsibility.” Fateh reflects on how the complexity of the human body inspired him to think more broadly about …
“Who would you go on a date with, and why?” That was the question that came up in a recent speech workshop. People shared fun, lighthearted answers. But for me, the answer came straight from my heart. I would go on a date with my dad.
My father passed away nearly fifteen years ago, just before my life was about to begin a whole new chapter. I was newly married, preparing …
This article is sponsored by Microsoft Dragon Copilot.
Physicians today face unprecedented pressures: …
An excerpt from The Savvy Physician: A Financial Wellness Handbook for Physicians and Professionals.
As a physician, helping people in need is among the greatest honors and privileges in the world. In the complex world of medicine, physicians and health care professionals have the opportunity and privilege to enormously contribute to patient well-being at a time of significant personal and/or family health crisis.
In addition, many physicians and health care professionals …
He was five, wiry, and fast, so fast his mother looped her purse strap around his wrist in the waiting room. She spoke softly, in Spanish, explaining that he could not sit still, could not sleep, could not stop. As she described his meltdowns, he interrupted with nonsense sentences, unrelated to her words, untethered from context. It was not defiance; it was overflow.
I and my team of CNA Spanish interpreters …
I have written here before about my growing conviction that coronary artery disease is not just about LDL, inflammation, or bad luck. It is time to talk about what might be the elephant in the cath lab: infection.
A recent pathology study out of Japan looked at coronary plaque samples from patients with symptomatic CAD. Using both immunohistochemistry and PCR, they found Chlamydia pneumoniae in every single sample. All fifty plaques …
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Neurologist Scott Tzorfas discusses his article “The crushing bureaucracy that’s driving independent physicians to extinction.” Scott shares his firsthand experience as a neurologist in private practice for three decades, where endless pre-authorizations, …
I’m going to say something controversial: the DPC community’s obsession with “purity” is missing the point. After two decades designing health care financial models, negotiating payer & vendor contracts, and building compliance frameworks, I’ve learned that most alternative payment models don’t fail because they’re impure. They fail because someone forgot to do the math.
When $1 million can’t save a bad idea
The University of Houston medical school launched a direct primary …
Some battles announce themselves with trumpets; others creep in silently, spreading their fire unseen. His battle was the latter. What began as a hidden spark in his muscles had grown into an inferno consuming his young body from within.
He was barely thirteen, a boy from Bihar, when fate dragged him into this fight. By the time he reached us, fever had bound him for three relentless weeks. His pulse was …
As physicians, we’re used to thinking about dose (how much medication, how often, and for how long). But there’s another dimension that’s often overlooked: time. For decades, we’ve known that the body processes medicines differently depending on the time of day. A blood pressure pill or chemotherapy drug can have markedly different effects depending on when it’s taken. This field, known as chronopharmacology, has transformed how we think about drug …
Larry is a friend. We are not besties. He is a neighbor, a few miles down the road from our forty-eight-acre hobby farm in our quaint little town, surrounded by farmland, generational farmers, rusted old tractors, cornfields, livestock, and a few homes interspersed in between. He is a neighbor, nonetheless. And a friend.
I first met Larry when we were building our country home, where my wife dreamt of raising a …
I am a cancer doctor.
It took me many years to become one and while I paid for my medical school tuition, my residency and fellowship training was partially subsidized by government funds for general medical education. Every residency and fellowship is partially funded this way because the government recognizes the need for doctors. I have also had an NIH funded basic research lab where I did research that has contributed …
California Governor Gavin Newsom recently made headlines for his marathon public appearances, speeches, and press briefings. Watching him, I could not help but wonder what his voice coach or speech-language pathologist might say. As a clinician who specializes in voice therapy, I see teachers, pastors, lawyers, and health care providers (people who depend on their voices every day). Politicians are no different.
Our voices are often our most valuable tool, yet …
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