I remember a night during my first year of residency in oncology when I was on call. It was after midnight, and I was sitting at the ward counter.
I often struggle to sleep during night shifts, especially when I’m the only doctor on call. I prefer to stay at the counter because I dread the thought of some terrible thing happening and not being able to reach the ward in …
What a dying patient taught me about compassion in silence
The message came through before dawn: “Our EHR is down. No access to patient charts.”
In a rural clinic, that is not just a technical inconvenience. It is the mother who drove forty miles before sunrise to get her child’s asthma medication, the farmer who left the fields to review his lab results, the elderly patient who cannot make another trip for months. When systems go dark, there is no backup …
When the clinic becomes the battlefield: Defending rural health care in the age of AI-driven attacks
The phone call from my insurance carrier came in unexpectedly one morning. “We see that you’ve just been discharged from the hospital …”
I blinked. I had neither been admitted nor discharged from any hospital. When I pressed for details, the caller claimed her records showed I’d been hospitalized for more than a month. Why? For which condition? She didn’t have that information, she told me. Only the dates.
My first thought: …
Poorly targeted patient outreach is wasted outreach
The truth is not hiding. We have known for decades what allows physicians to thrive and what erodes their well-being. The science has been published, the interventions described, and the solutions tested. What we face is not a crisis of knowledge; it is a crisis of action.
I was reminded of this recently when an emergency physician preparing a talk on wellness asked me for help. She wanted to share with …
Ending burnout through structure, not gimmicks
For years, I didn’t realize the name for what I was experiencing as a primary care pediatrician was burnout. I just thought I wasn’t enough—not good enough, not hardworking enough, not experienced enough. That self-doubt didn’t stay confined to my role as a doctor; it crept into how I felt as a parent, a spouse, a community member.
Nothing ever felt like enough. So I did what I was trained to …
The silent burnout epidemic among parents and doctors
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Physician executive Laura Kohlhagen discusses her article, “Here’s what providers really need in a modern EHR.” She argues that since electronic health records were originally designed for billing and …
How AI is finally fixing the electronic health record [PODCAST]
When I was a new hospitalist in a tertiary center, I once told a colleague, “Looks like I got an easy admit.” He just stared at me.
It didn’t take long to understand why.
Vitals can be stable. Labs can look clean. But patients—especially those we assume are “simple”—rarely are. There’s a language beyond numbers: the way a patient breathes, a hesitation in their tone, the look in a spouse’s eye. Over …
Why AI must support, not replace, human intuition in health care
When a patient walks into an orthopedic spine clinic, most providers are focused on one thing: the back. But after over a decade of caring for patients with chronic pain, I noticed something deeper lurking behind the disc herniation and spinal stenosis: depression. And it was not being addressed.
That is why I launched a quality-improvement (QI) project focused on integrating depression screening into the routine evaluation of orthopedic spine patients. …
The link between chronic back pain and depression
Once upon a time there was a pandemic, despite what the “deniers” and conspiracy theorists say. This rare disease outbreak shook every corner of the globe, yet brought out the best in people, people who put their lives on the line to care for the sick and dying.
But to this day, I still hear and read about folks who are convinced the COVID-19 pandemic was blown out of proportion and …
COVID-19 was real: a doctor’s frontline account
My recent experience as a cancer patient has illuminated many things. It has shown me how our health care system is not standardized and how it sometimes makes patient care decisions based on financial incentives or convenience rather than patient preferences or best clinical practice. Take, for example, the topic of sedation.
The question of whether to sedate is common in pain management, which often involves invasive intraspinal procedures such as …
Why sedation access varies by clinic and hospital
I have been a physician for 44 years.
Besides my office and hospital practice, I also make house calls for less mobile older adults. We all want to stay in the homes where we raised our children, cared for our gardens, and became part of the community. The reality is that we lack the tools and financial resources needed for seniors to “age in place.”
My house calls, though, have provided insights …
Aging in place: Why home care must replace nursing homes
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Academic physician executive William Wertheim discusses his article, “America, our health care workforce training isn’t evolving alongside our needs.” He argues that the U.S. medical system is training professionals who will not …
Why America’s medical training pipeline is failing our future [PODCAST]
We had been trying, but the moment you see the word on the test strip, reality hits differently. My career was on an upward trajectory—I had just been offered a major promotion. And all I could think was: Why now?
When I told my husband how nervous I felt, he assumed it was about my body changing, or how our family of two would soon become three. He was wrong—and visibly …
The silent challenges of female leadership in medicine
We’ve medicalized nearly everything in life—birth, aging, sleep, even boredom. Now, in the spirit of efficiency, we’ve begun medicalizing death itself.
In his unsettling essay “The European way to die,” French novelist Michel Houellebecq warns that the normalization of euthanasia and assisted suicide is not a sign of progress but of profound cultural decay. I didn’t expect to find myself agreeing with him.
As a physician for over three decades, I’ve …
Why medicalizing death could strip it of meaning
The gut-brain axis is a key player in mental illnesses such as schizophrenia, bipolar disorder, depression, and anxiety.
The intestinal microbiome (the foundation of the gut-brain axis) influences brain function through bidirectional communication via neural (vagus nerve), immune (cytokines), and metabolic pathways. Microbiota alterations may also impair hypothalamic-pituitary-adrenal axis regulation, which, in turn, affects both psychological stress level (cortisol) and whole-body hormonal balance. What’s more, microbial metabolites (such as short-chain fatty …
How gut bacteria shape your mental health and mood
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Psychiatrist Sabooh S. Mubbashar discusses his article, “Why ‘do no harm’ might be harming modern medicine.” He reveals that the principle “First, do no harm,” or Primum non nocere, is not part of the original Hippocratic Oath but a later, misattributed addition that has become a dangerously oversimplified slogan. …
Is “do no harm” the most misunderstood phrase in medicine? [PODCAST]
Monopolies thrive on control. In U.S. health care, that control is quietly breaking the system from within. Today, a small group of supplier-funded entities, including GPOs, PBMs, EHRs, MMIS vendors, and EDI platforms, dictate costs, suppress innovation, and hoard the data that hospitals need to operate effectively.
If we want real health care reform, we must start with monopoly reform.
1. Skyrocketing costs driven by opaque contracts. When a handful of players …
Why health care reform must start with ending monopolies
When I first saw the CDC’s MMWR latest report on obesity medication prescribing for adolescents, my initial reaction was probably the same as yours: less than 1 percent of teens with obesity got these medications in 2023? That seems pretty dismal.
But then I took a step back and looked at what this data is telling us. And honestly? We’re missing the real story here.
We’re witnessing something historic.
Think about where …
Why new obesity medications for teens could be a game changer
Alzheimer’s disease is a ruthless thief, silently stealing the essence of our identities: our memories. It robs us of cherished moments, meaningful relationships, and the independence that makes life vibrant and fulfilling. Traditionally viewed as an inevitable consequence of aging or genetics, groundbreaking research now challenges this perspective, suggesting Alzheimer’s may actually be a form of metabolic disorder aptly coined Type 3 diabetes.
The concept of Alzheimer’s as Type 3 diabetes …
How insulin resistance may cause Alzheimer’s disease
History has a habit of repeating itself.
Just prior to the 1929 crash, ads supporting the presidential candidacy of Herbert Hoover promoted a tag line promoting prosperity that has lived in infamy: “A chicken for every pot and a car in every garage.”
Now we have Robert Kennedy—our Secretary of Health and Human Services, the cheerleader for the “Make America Healthy Again” movement—promoting another grand idea to solve our nation’s …
Why smartwatches won’t save American health care
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