She whispered when she said “panic attacks.”
Not because she thought I would judge her or fail to understand. But because she was a physician, and in her world, saying the wrong thing to the wrong person could cost her everything.
She found me through a colleague of a colleague. No insurance, no documentation trail, no diagnostic codes, no third-party systems. She paid in cash. She never used her full name.
“If I …
Rifaximin, a minimally absorbed antibiotic, has become a cornerstone therapy for several gastrointestinal disorders, including irritable bowel syndrome with diarrhea (IBS-D) and hepatic encephalopathy. Despite its established use, access to rifaximin varies significantly across global markets, with cost barriers posing challenges in some regions. In contrast, in many Asian countries, the same medication is available at a fraction of the price, raising important questions about pharmaceutical pricing practices and access …
Explosive trace detection systems at airport checkpoints are designed to identify minute quantities of explosive materials through techniques such as ion mobility spectrometry. However, their high sensitivity comes at a cost: False-positive alarms can occur when common substances chemically resemble explosive agents. In dermatology, this includes topical medications and moisturizers containing glycerin or nitrates, compounds that are chemically similar to …
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Physical therapist John Corsino discusses his article, “Lifelong learning: a game-changer in diagnosing dizziness.” He highlights how often the answers to complex cases, like acute dizziness, are present in the exam room but can …
We’re constantly reminded of the organ shortage and the lives lost while waiting for a kidney. Like fish unaware they swim in water, we’ve accepted the rising tide of kidney failure as natural and inevitable, but it’s not. The most urgent question goes unasked: Why do so many kidneys fail?
Diabetes is the leading cause of kidney failure, with 40 percent of those on the kidney waitlist diabetic. Every day …
In medicine, we’ve long relied on the oxygen mask analogy to justify self-care: “Put your own mask on first before assisting others.” It’s a powerful image—but it’s not enough.
Oxygen masks drop in emergencies. Putting them on is a reactive action. They keep us alive—but they don’t help us thrive.
For many physicians, the oxygen mask has become the gold standard of wellness. In a culture that rewards self-sacrifice and martyrdom, “putting …
The physician shortage in the United States is a real and urgent issue. Projections from the Association of American Medical Colleges (AAMC) estimate that by 2034, the nation could face a deficit between 37,800 and 124,000 physicians. Primary care will be particularly affected, with a potential shortfall of up to 48,000 doctors. Rural and underserved communities will likely bear the brunt of the burden.
This shortage stems from multiple …
An excerpt from Super Agers: An Evidence-Based Approach to Longevity.
For many years, my colleagues and I have been fascinated by individuals like Mrs. L. R., who are so lucky to be so resilient to diseases. In 2008, we set up a research project called “Wellderly,” to study people who were at least eighty years old and had never been sick or had a chronic illness. It took almost six …
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Former American College of Physicians treasurer and infectious disease physician Janet A. Jokela discusses her article, “Internal Medicine 2025: inspiration at the annual meeting.” She shares her personal reflections on the profound …
After twenty-five years of dedicated service as a physician, overcoming a severe neurological illness taught me that medicine embraces patient recovery—but not physician recovery. I never imagined returning to practice after illness would mean humiliation, suspicion, and unnecessary trauma. Yet, that is exactly what happened.
When my illness took me away from clinical practice for over three years, I anticipated hurdles returning to medicine. I understood the need for a competency …
In ancient times, there were oracles and soothsayers. In the 1950s, risk management becomes a science. Nevertheless, there are 85,000 medical malpractice lawsuits filed per year. They are problematic, not because they overwhelm court dockets, but because a disproportionate number of claims are either frivolous or, if meritorious, are not represented. Also, each physician, myself included, has an 8.5 percent chance per year of being sued for a bad result …
I have previously blogged about identifying your practice’s UVP or unique value proposition. This is based on differentiating your practice from others in the community or the region. According to an article in the Wall Street Journal, workplaces are pumping fragrances into offices to make the offices smell better. The article focused on real estate properties in Manhattan trying to lure renters back to the workplace after the pandemic. …
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Health care executive Traci Sweet discusses her article, “The role of contingency management in addiction treatment.” She makes a compelling case for the increased use of contingency management—an evidence-based approach utilizing positive …
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Over 80 percent of people are discontented with their medical insurance, whether provided by the government, their employer, or a commercial company. Common complaints are cost, increasing prices, and limited or rejected coverage. Regardless of the insurance’s source, we, the citizens, pay the bill through higher co-payments, deductibles, or premiums. Thus, their future payments increase when people request increased coverage for specific treatments, tests, or conditions.
However, individual desires are not …
We were taught that sacrificing ourselves is noble. That resilience is enduring. And that suffering and struggling are valiant.
We were taught rest is optional, complacent, lazy—something for other, less busy, less important people.
We were also taught to see “self-care” as somewhat indulgent.
Self-care is often thought of as something earned. A guilty pleasure.
Even the words commonly used in medicine to describe caring for ourselves—”self-care”—sound indulgent.
“Caring for ourselves as well” is not …
Lose weight and you’ll be happy,
They say …
I wasn’t happy,
I was exhausted and depleted.
You’re so disciplined,
They say …
As I starved myself
And had to earn my food.
I wish I could have your problem,
They say …
Brainwashed into thinking,
Smaller is better.
How do you always eat so “healthy”?
They ask …
While my list of “safe” foods
Grows shorter and shorter.
As I dream of being free
And escaping the prison in my mind …
They wonder how to be …
I was, without a doubt, in a desperate place—going back to school after not taking a math course in over six years and attempting to study calculus. It was as stressful as it sounds. Like so many of the students in my post-baccalaureate cohort, we deeply valued our education at this point—which is not surprising, considering we all had to work jobs to pay for it. But luckily, I had …
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Registered dietitian Ava Safir and physician advocate Kim Downey discuss their article, “Why patients need a registered dietitian on their health care team.” They highlight the often-overlooked yet crucial role registered dietitians …
The health care system, in theory, operates on one fundamental principle: to prioritize patient welfare. Yet, contemporary systems in many regions, particularly the United States, have increasingly veered off course, entangling themselves in a jungle of bureaucracy, regulation, and profit-driven motives that obscure the vital role patients play as the focal point of care. The result is a system riddled with inefficiencies, frustration, and barriers to optimal health care delivery.
I read Dr. Harry Severance’s recent piece, “Violence in health care: Why doctors and nurses are leaving,” with a sinking feeling of recognition. He’s right. Health care is becoming the most dangerous profession in America. Violence is no longer rare or shocking—it’s something every physician and nurse now half-expects at some point in their career.
I still remember an early shift in the ER when I was stitching up a …
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