It begins with thunder. Not just the kind that splits the sky, but the kind that settles into the chest — low, rolling, remembered. It’s been years since the hurricane, but each crack of lightning still pulls my body into defense. I never used to be afraid of storms. Now, my body remembers before my mind does.
That night, I was post-call. Exhausted, planning to ride out the storm the way …
How a doctor defied a hurricane to save a life
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Critical care physician Jess Bunin, co-founder of All Levels Leadership, discusses the article, “Civil discourse as a leadership competency: the case for curiosity in medicine.” They challenge a core tenet …
Civil discourse as a survival skill in health care [PODCAST]
Words matter.
In a recent conversation with a physical therapist friend who lives with chronic illness, she shared that the term “wellness” doesn’t resonate with her—it feels like an impossible state to attain. She prefers “well-being,” explaining that it more accurately reflects how she feels and functions in daily life.
Over the past couple of years, I’ve spoken and written about physician wellness and well-being, often using the terms interchangeably. But that …
Focusing on well-being versus wellness: What it means for physicians (and their patients)
Surthriving in the brave new world of sick care requires not just a new playbook, but players with new skill sets to execute the plans. Knowledge technicians are as obsolete as an NFL team with a running game but without a passing and special teams plan. Unfortunately, HR managers are getting it wrong. The biggest risk to future success and becoming a disruptor is a company’s existing …
Why hiring physician intrapreneurs is the future of health care leadership
The so-called “One Big Beautiful Bill” was passed by both houses of Congress and signed into law by the president on July 4, 2025. This bill will have a sweeping impact on the already declining health care landscape in America.
If you’ve been feeling a mix of confusion and frustration, you’re not alone. This isn’t just policy. This is your career, your practice, and your patients.
This bill brings the largest cuts …
How the One Big Beautiful Bill could reshape your medical career
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Pediatrician and certified life and weight coach Karla Lester discusses her article, “An effective treatment using an effective care delivery model: Using telehealth to treat adolescents with obesity with GLP-1 medications.” She …
A new telehealth model for adolescent obesity [PODCAST]
I like quails. They resemble sparrows but are slightly larger. Quails are relatively quiet and easy to keep since they cannot fly much, unlike sparrows. They have a good lifespan as well. Since childhood, I have raised many quails, and I currently have two that I bought in 2023.
The quails have aged significantly, and the male has plucked many feathers from the female’s body. As a result, there are bald …
Love, birds, and fries: a story of innocence and connection
An excerpt from Crave: The Hidden Biology of Addiction and Cancer.
Prevention, as commonly understood, has struggled to match the evolving reality of cancer. The traditional model rests on two main ideas: Reducing exposure to known carcinogens and detecting abnormalities as early as possible. Avoid tobacco, wear sunscreen, and get screened. These recommendations remain useful, yet they are incomplete. They overlook the terrain in which disease develops. They address threats …
Why the future of cancer prevention starts from within
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Cardiologist Monzur Morshed discusses the article, “Why South Asians in the U.S. face a silent heart disease crisis.” Drawing from his direct experience treating the Bangladeshi-American community in New York City, Monzur …
A new approach to South Asian heart health [PODCAST]
Physicians joining private practices have a relatively new issue they should be aware of. As more practices are taken over by private equity, the traditional concerns of a physician joining a practice as an employee with the hope of becoming an owner are heightened.
Traditionally, the physician would join the practice as an employee, work for a few years, and get the “golden ring” of ownership after a few years. Often …
Private practice employment agreements: What happens if private equity swoops in?
This story has been fictionalized.
Dorothy Klein. MRN 508291987. DOB 12/22/1962. Patient A-. Unit A-. Unit number W038306745014-K.
OK. Next.
Dorothy Klein. MRN 508291987. DOB 12/22/1962. Patient A-. Unit A-. Unit number W038306928906-K.
We finish checking the emergency release blood and wait. We know that whatever was coming up isn’t going to be pretty. A lung transplant gone bad, uncontrolled hemorrhaging, 14 hours on the table. So much blood transfused, an exploratory laparotomy was …
Inside the final hours of a failed lung transplant
Although cardiovascular disease (CVD) is the world’s largest cause of mortality, its burden varies by ethnicity. People from South Asia, including Bangladesh, Sri Lanka, Nepal, India, and Pakistan, are among the groups most at risk for developing coronary artery disease too soon. However, this population frequently receives standard risk assessments in clinical practice across the U.S. that do not take ethnic-specific risk factors into consideration, which results in underdiagnosis and …
Why South Asians in the U.S. face a silent heart disease crisis
At age 81, I am one of “the old guys” who writes in online chronic pain support groups. I get a lot of emails from people in pain. One recent inquiry was from a lady named Marisa, who asked questions that are combined in the title of this article. The following is my response to Marisa and others.
My wife is a chronic pain patient who has multiple medical issues. I …
Why chronic pain patients and doctors are both under attack
When most of us as providers think about success in primary care, we focus on patient volume, quality of care, or time management. But in my opinion, there is a less glamorous (yet absolutely vital) area that can determine both our income and our liability: billing accuracy.
Billing is not just about codes and claims. It is the foundation of our financial health and a critical layer of legal protection. When …
The overlooked power of billing in primary care
The first thing I remember is the sound of oxygen at night.
It was my second week as a hospice nurse. I had just pulled up to a modest home on a cul-de-sac, the kind of place where wind chimes echo off empty sidewalks. Inside, a man in his seventies was dying of end-stage pulmonary fibrosis. He was surrounded by family, but it was that soft hiss—steady and rhythmic, like an …
The quiet work of dying: a hospice nurse’s reflection
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Dr. Lorna Breen Heroes Foundation co-founder Corey Feist and physician advocate Kim Downey discuss their article, “Health workers deserve care too: How to protect their mental health.” They highlight the ongoing mental …
A systemic plan for health worker well-being [PODCAST]
Pain management physicians, who often prescribe controlled substances like opioids, face intense scrutiny. Critics argue that investigations are overly aggressive, resembling fishing expeditions where investigators search broadly for any evidence of wrongdoing, often beyond the original complaint. A 2023 Los Angeles Times report noted that nearly 10,000 investigations were conducted in 2021–2022, with pain physicians disproportionately targeted due to outdated guidelines predating modern evidence-based practices. For example, the reliance on …
Why pain doctors face unfair scrutiny and harsh penalties in California
Physicians are masters at holding it together.
You walk into a patient’s room, and no matter how little sleep you have gotten, how chaotic the last shift was, or how much is weighing on you personally, you put on the calm, capable, competent face that patients and colleagues expect. That ability to compartmentalize (to suppress your own emotions so you can stay functional) is often what gets you through residency, twenty-four-hour …
Why physicians need a place to fall apart
Sepsis, multi-organ failure, near death
I fought back to the work I loved.
Life shifted; teaching’s call opened another door.
Not time yet.
The student clinic, a rebirth at the bedside,
Watching timid M1s bloom into confident, caring M3s: pure joy.
Being a doctor, teaching, healing, helping those in need.
Not time yet.
The pure fun of light bulbs igniting in small groups,
Connecting with so many bright, caring young minds,
Knowing medicine’s future is secure through them.
Not time yet.
Another …
The joy of teaching medicine through life’s toughest challenges
We don’t send SEAL teams into the field without backup, but we routinely send health care workers into no-win situations and tell them: don’t fail.
I celebrated friendship and teamwork during a Change of Command ceremony this week—full of honor, tradition, and those stirring reminders of what it means to lead. But one repeated phrase stuck in my craw: “This is a no-fail mission.”
It’s meant to inspire. It’s meant to light …
Why health care can’t survive on no-fail missions alone
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