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This article is sponsored by Eli Lilly and Company.
In this special sponsored episode from Eli Lilly and Company, I am joined by Dr. …
Why early detection matters: Transforming lung cancer care [PODCAST]
When I began coordinating GI research in inflammatory bowel disease (IBD), I noticed something unexpected: Second- and third-year GI fellows, bright, motivated, steeped in medical science, had received little to no formal training on diet’s role in disease. For many, nutrition was treated as peripheral, “something dietitians handle,” rather than core physician knowledge.
This is not a reflection on their ability or commitment. It reflects how medical education is structured. U.S. …
Why clinician education must prioritize nutrition training
I read a recent JAMA Viewpoint on medical trainee unions not just with disappointment, but with a deep sense of recognition. It presents a narrow and skewed interpretation of unionization, framing it not as a response to systemic dysfunction but as a threat to medical education and hospital finances.
We do not unionize for marginal gains or lighter schedules. We are responding to an embedded educational hierarchy that excludes us …
Why residents unionize: systemic reform, not entitlement
There is a resident doctor on TikTok named Julia who is also a raver. She posts about her training, and her weekends, dancing, festivals, après ski, living a full and visibly joyful life outside the hospital. The comments on her videos are glowing. “I would love to have a doctor like you.” “You seem like a real person.” A lot of patients are not looking for a self-sacrificing doctor who …
Moving beyond the false binary of medicine as a calling
It keeps us up at night. We pay thousands to hundreds of thousands of dollars a year to protect ourselves from it. Our hospitals or practices have entire departments dedicated to managing it.
It is “Risk.”
Avoiding risk is an inherent part of modern medicine. Every day, we practice CYA documentation, ensure our patients sign informed consent forms, and do everything we can to minimize the risk that someone will sue us …
Physician financial risk: Balancing capacity and tolerance
Artificial intelligence, or “AI,” is fast becoming indispensable to modern medical practice. Whether they are using complex prognostic algorithms to model possible disease outcomes or they are upgrading medical bookkeeping applications, physicians employ various forms of AI to aid in daily tasks. And while these tools can produce unprecedented benefits, the increased incorporation of AI in medical practice also brings with it a number of key cybersecurity challenges. Medical information, …
Navigating the cybersecurity challenges of artificial intelligence in medicine
“Doc, I cannot sleep well at night since I started taking the blood thinner (apixaban/Eliquis).”
“Hmm, that is not a typical side effect of the blood thinner. Have you considered any other changes to your routine that could be affecting how you sleep at night?”
“Doc, I also have joint pains and diarrhea since I started the blood thinner. Can I stop it?”
(The patient has had joint pains and diarrhea pre-dating the …
When side effects are actually a cry for help with medication costs
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Patient advocate Richard A. Lawhern discusses the article “U.S. opioid policy history: How politics replaced science in pain care.” Richard argues that for decades, public policy on pain treatment has been driven …
Politics and fear have replaced science in U.S. pain management [PODCAST]
A systematic review was conducted following PRISMA 2020 guidelines. Databases (PubMed, Embase, Scopus, Westlaw, LexisNexis) and gray literature were searched from January 2010 to November 2025 using terms related to medical board discipline, pain management, and overreach. Eligibility included studies, legal cases, and reports on disciplinary actions, due process violations, or consequences for physicians/patients.
Findings of 1,847 records, 42 were included (28 journal articles, eight legal cases, six reports). Key abusive …
How punitive board tactics are harming pain management physicians
The schedule is already behind. It is always already behind. In a family medicine clinic on an ordinary Tuesday, I open a chart and watch an AI tool do what it was built to do: draft the note, compress the story, produce an assessment that reads clean, confident, complete. For a moment it feels like relief, the kind you learn not to trust. Then the woman across from me says, …
AI in clinical documentation: the hidden risk of automation bias
If the computer is getting more of our attention than the patient, we have a problem. It is not a small annoyance. It is not just part of the job. It is pulling clinicians away from patients, draining attention from the exam room, and quietly chipping away at the quality of clinical education. We can debate workflow, efficiency, and EHR optimization all day long. But here is what I see …
Can AI scribes give clinicians time to teach again?
As I approach the 10-year anniversary of hearing the words “I am 99 percent sure you have breast cancer,” I have many emotions: gratitude, fear, anxiety, hope. Having been diagnosed with stage 3 breast cancer in 2016, then learning it had metastasized to my liver, so stage 4, I had so many questions and so much uncertainty.
Since then, it has been a journey of self-reflection, relationship evaluation, insurance negotiations, family …
Surviving stage 4 breast cancer: a 10-year journey of hope
In lifestyle medicine, we know the script: eat better, move more, manage stress, sleep well, connect with others. Many of us know what to do. But knowledge alone does not create transformation. What does? Identity. That quiet internal voice that tells us who we are and what we are capable of. Research by Daphna Oyserman and colleagues shows that identity drives behavior …
Why immersive travel may be a powerful tool for behavior change
Everything we know about keeping people alive under pressure we learned from war. Triage was invented on a Napoleonic battlefield. Tourniquets, hemostatic dressings, damage control resuscitation, the golden hour itself. Military surgeons figured out how to stop bleeding and move casualties while the ground was still shaking, and civilian medicine inherited every lesson. The emergency department and the battlefield have always been adjacent theaters, running the same protocols under different …
Health care cyberattacks expose a critical national security failure
Every spring, millions of families across Chinese communities around the world travel back to their hometowns for Qingming Festival, often translated as “Tomb-Sweeping Day.” It is a centuries-old tradition of honoring ancestors. Highways fill with traffic. Families gather at gravesites to clean tombstones, burn incense, and leave offerings of food. On the surface, Qingming is about remembering the dead. But in many homes, the holiday quietly exposes a different reality: …
The hidden cost of long-term care policy for family caregivers
Update from Oregon Health & Science University:
Oregon Health & Science University clarifies that no decisions have been made about the Oregon National Primate Center at OHSU.
In February, the OHSU Board of Directors authorized the university president to enter discussions with the National Institutes of Health about the possibility of transitioning the ONPRC to a primate sanctuary.
The board passed a resolution to begin a six-month timeframe for the parties to develop …
Why the Oregon National Primate Research Center is shutting down
Many physicians see fee schedules, payment rates, billing codes, and pension negotiations as administrative work best left to a few elected representatives, policy experts, or government staff. However, these physician payment tariff negotiations shape how care is delivered, how practices remain viable, how new services are recognized, and how the profession sustains itself over time. They involve fee codes, billing rules, payment rates, service descriptions, pensions, compensation models, and allocation …
Why physicians must lead payment tariff negotiations
I was halfway through my first year of OB-GYN residency when I learned that my brain had been working against me my entire life. By then, I had passed licensing exams, matched into a surgical specialty, and learned how to function convincingly while exhausted. What I had not learned, and what medicine never taught me, was how to recognize when “high functioning” was actually quiet suffering. And that distinction matters, …
ADHD in physicians: Why medical training punishes neurodiversity
Most physicians know what they earn. Far fewer know what it costs to hire them or replace them. A colleague once told me in frustration, “It takes me two years to get my money back on a new hire.” I understood the frustration, but not the math. I thought of hiring the way many physicians do: salary, benefits, maybe a signing bonus. It seemed straightforward. It is not. Hiring a …
The hidden math behind physician hiring costs and recruitment
It is time to dethrone the office visit as the king of primary care physician compensation and how the work of a primary care physician is defined.
Several months ago, a reporter asked me how many patients I see in a typical day. I told her that the question should not be how many patients I see each day, but how many patients I take care of each day, a number …
Primary care compensation models: Why wRVUs are obsolete
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