The patient carryover crisis: Why discharge education fails

Conditions
November 28, 2025

I still remember the feeling of relief standing by my uncle’s bedside. The monitors were humming with steady rhythms; the surgical team was congratulating themselves on a textbook procedure. By all clinical metrics, he was a success story. The intervention worked. The pathology was addressed. He was “stable.”

We celebrated his discharge as a victory lap. We trusted that the packet of papers in his hand (filled with appointments, medication schedules, …

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Why diagnostic error is high in offices

Conditions
November 28, 2025

The National Academy of Medicine defines diagnostic error as “the failure to (a) establish an accurate and timely explanation of the patient’s health problem(s) or (b) communicate that explanation to the patient.” Office-based practices are the predominant setting for malpractice claims related to diagnostic error.

Yes, office-based care settings.

Fast-paced, high-acuity emergency departments (EDs) have fewer malpractice claims related to diagnostic error than physician offices, according to recent research. Furthermore, 53 …

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The myth of no frivolous medical lawsuits

Physician
November 28, 2025

“No medical malpractice lawsuit is frivolous,” is the narrative echoed by plaintiff attorneys. Medical malpractice lawsuits are vastly underrepresented. Also, because frivolous lawsuits are too expensive to litigate, expense is a natural deterrent for filing one. Plaintiff attorneys have controlled this narrative for as long as I’ve been in practice since 1972.

Recently, I examined the veracity of this claim. Indeed, there are 66 million civil lawsuits filed in the …

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A pediatrician explains the real danger of food perfectionism [PODCAST]

Podcast
November 27, 2025
YouTube video

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Pediatrician Wendy Schofer discusses her article, “Why food perfectionism harms parents.” Wendy explains how the intense worry over family eating habits and ultraprocessed foods is often a symptom of a deeper issue: …

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Divorced during residency: a story of clarity

Physician
November 27, 2025

Keeping my head down and working through intern year was all I had known. My days blurred into nights, and my weeks into months. The dreary Pacific Northwest winters had only compounded this. Despite a quiet yearning for connection and community, I declined most social invitations. My sense of obligation did not end at the hospital doors. It followed me home, where expectations and emotional responsibilities lingered. I often felt …

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Medical statistics errors: How bad data hurts clinicians

Conditions
November 27, 2025

Last winter, a senior nurse in our psychiatric unit told me, “The dashboard says we’re low-risk. But during night shifts, I don’t even feel safe walking to the bathroom.”

The monthly quality report on her desk said the same thing it had said for nearly a year: “Violence incidents: no significant difference among the three wards (p > .05).”

On paper, her ward looked normal. At the bedside, it was anything but.

Her …

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Why food perfectionism harms parents

Conditions
November 27, 2025

The recent Atlantic article by Olga Khazan, “Avoiding Ultraprocessed Foods is Completely Unrealistic. Especially if you have kids,” brought a concern that I’ve carried for a long time into full clarity: Our worries about family weight and eating habits aren’t actually about the physical body. They’re about perfection. And they are a call to approach health completely differently.

I am a pediatrician working at the intersection of family stress, emotional …

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A husband’s story of end-of-life care at home

Physician
November 27, 2025

The British tend to use the term “carer” for the people who help other persons with needs. It seems to emphasize its root word, care, with implications for family members, volunteer helpers, and professionals who fill that role. The American term tends to be “caregiver;” its usage has become more common.

Even when I worked in health care, I had never used either of those terms. But over the last fifteen …

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Why being your own financial planner is costing you millions [PODCAST]

Podcast
November 26, 2025
YouTube video

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Certified financial planner Michelle Neiswender discusses her article, “Why physicians should not be their own financial planner.” Michelle explains why physicians, despite being brilliant, often make costly financial mistakes when managing their …

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The H-1B crutch in rural health care

Physician
November 26, 2025

In the vast, undulating expanse of rural America (those counties where the horizon stretches like a taut bowstring, evoking the stoic endurance of Steinbeck’s Joads) one might expect the pulse of health care to beat with the resilient rhythm of native ingenuity. Yet, as a recent study in the Journal of the American Medical Association reveals, physicians sponsored under the H-1B visa program are twice as prevalent in these bucolic …

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Autism prevalence surveillance: a reckoning, not a crisis

Conditions
November 26, 2025

A recent Wall Street Journal graphic traces the rise in autism prevalence among eight-year-olds from 2000 to 2020. The slope is unmistakable, upward, steady, and steep. But it’s not a crisis. It’s a reckoning.

Each inflection point on that chart marks a milestone in institutional clarity:

  • 2000: The CDC begins formal autism surveillance.
  • 2007: The American Academy of Pediatrics urges universal screening at …

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Physician income vs. burnout: Why working harder fails

Physician
November 26, 2025

I strongly believe that working harder in medicine is making us as doctors poorer, and it’s quietly harming patients too. Not because we don’t care, but because rushing destroys the very thing patients need most: Time, attention, and real care.

Let me explain.

If you’re a medical doctor or another primary care clinician, you’ve probably heard this your whole career: “Work harder. Work faster. See more patients. Push more. Do more.” And …

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Our relationship with medicine: a triumph

Conditions
November 26, 2025

Take a look in your medicine cabinet. What you see isn’t a sign of weakness; it’s a testament to one of the greatest partnerships in modern life: the one between your body and medical science. From the vaccine you got as a kid to the pill that keeps your blood pressure in check, these interventions aren’t just treating sickness. They are part of who you are. In a world still …

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Rediscovering the sacred power of the patient story [PODCAST]

Podcast
November 25, 2025
YouTube video

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Professor and senior associate dean of engagement Janet A. Jokela discusses her article, “Celebrating internal medicine through our human connections with patients.” Janet shares moving stories from medical students who are discovering …

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The human element in clinical trials

Physician
November 25, 2025

I have often heard people speak of numerology, weaving destinies around digits. They say that behind every event in a person’s life lies the hidden hand of numbers. I do not know if such beliefs hold scientific truth. Yet, in medicine, numbers certainly matter. Numbers fill our trial registers, power our statistics, shape our protocols. In research, life is reduced to codes, columns, and counts.

As a medical student, the jargon …

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Is direct primary care sustainable in a downturn?

Conditions
November 25, 2025

Primary care innovation has always been framed around access, autonomy, burnout, and patient experience. Direct primary care (DPC) in particular is often positioned as a solution for physicians exhausted by fee-for-service complexity and for patients who want a more personal relationship with their doctor.

This article focuses on how the broader economic landscape has shifted in ways that directly affect DPC, especially in light of the rapidly evolving national discussion around …

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The Silicon Valley primary care doctor shortage

Physician
November 25, 2025

Not long ago, a friend told me, “I switched insurance and can’t find a doctor who will take me.” Another said, “I left Kaiser after going on Medicare and now no one will see me.” These aren’t isolated complaints. They’ve become the new reality in Silicon Valley: It’s easier to buy a multimillion-dollar home than to find a new primary care doctor.

I saw this problem firsthand before I retired from …

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Transforming patient fear into understanding through clear communication [PODCAST]

Podcast
November 24, 2025
YouTube video

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Counselor and certified coach Mary Remón and oncologist Tiffany Troso-Sandoval discuss their article, “Clear communication is kind patient care.” They explore the common scenario of patients leaving the office more confused and …

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How movement improves pelvic floor function

Conditions
November 24, 2025

Most people exercise to improve cardiovascular fitness, metabolic health, or mood, but regular physical activity also plays a significant role in sexual and urinary function. As a urologist, I routinely see how movement influences two intimate yet essential systems: the reproductive system and the lower urinary tract.

When patients present with urinary leakage, erectile changes, or reduced libido, they often expect a prescription or procedure. Yet for many, measurable improvement begins …

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How immigrant physicians solved a U.S. crisis

Conditions
November 24, 2025

Adapted from The Care of Foreigners: How Immigrant Physicians Changed US Healthcare. Copyright 2025. Published with permission of Johns Hopkins University Press.

In the decades following the passage of the Hart-Celler Immigration and Nationality Act of 1965, the face of American medicine irrevocably changed. This bill expedited the rapid entry of physicians from post-colonial Asian nations into the U.S. in significant numbers. In this migratory flow, South Asian physicians, in …

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