You see it before the final whistle blows. A boy—ten, or maybe nine—walks off the mat like he’s carrying bricks on his back. His face is red, his eyes damp. Waiting for him is his father, arms folded like a verdict. “You lost to that kid? You were up by two.” The boy opens his mouth, but nothing he says will be enough. The response is swift: a shake of …
Extreme weight cutting harms health and resilience in youth wrestling
Throughout my academic career I learned that medicine can be pursued through any major. Although the traditional path is through biology, as long as the correct prerequisites are taken, you are eligible to apply. As time went on, I began to think to myself, “Why isn’t there a common pre-med major?” This major would set students up to conquer the rigorous curriculum of medical school. Additionally, if students decide not …
The case for a standard pre-med major in U.S. universities
Lately, I have seen a few instances where physicians have been tricked by a term in their physician employment agreement that clearly does not mean what the physician thinks it means.
The most recent example came when I was negotiating a physician employment agreement, and the physician suggested verbiage concerning her scheduling. The physician suggested that we ask for language that the employer would develop a clinical schedule “after consultation with …
A physician employment agreement term that often tricks physicians
In the once-venerable corridors of our state’s flagship academic hospital, a slow-motion disaster is unfolding. White patients — yes, white patients, because that’s who’s leaving — are abandoning ship, hightailing it to the quieter, politer hospitals in “white” suburbs. Why? Because the “uniformly Mexican” staff — medical assistants, front desk drones, and nursing staff — treat customer service like it’s a foreign concept. And frankly, it is. Mexico isn’t exactly …
Why patients and doctors are fleeing flagship hospitals
I’ve taken some amazing vacations. Seriously—scenic, memorable, cool stuff. Travel has always been a top financial priority for me. It felt like one of the few things in life that reliably gave me joy and perspective.
And in many ways, I still believe in the value of taking time away. But over the past year, my perspective on why I take vacations—and what I’m actually hoping to gain—has changed in some …
The hidden reason your vacations never feel like enough
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Infectious disease physician Janet A. Jokela discusses her article, “Measles is back: Why vaccination is more vital than ever.” Recounting her own experience diagnosing a case in the 1990s, Janet contrasts that …
Confronting the return of measles and vaccine misinformation [PODCAST]
A few years ago, I said something in a meeting that made the air go still.
“People don’t actually feel safe filing ‘safe’ reports.”
I said it to a room full of leaders from the quality and safety team, the very people tasked with building trust and accountability. They didn’t argue. They just didn’t believe me.
They pointed to the anonymous portal. The reporting dashboard. The just culture training modules. They cited infrastructure.
I …
Institutional reporting systems discourage clinical honesty
You’re in the OR. A colleague, maybe a resident, suggests a different approach. You’ve already considered it. Or maybe it’s not a great suggestion. Either way, it’s hard to hear. You feel your muscles tense and lean away from your colleague, avoiding eye contact. Defensiveness is a common and understandable dynamic.
A common dynamic
In the era of shared decision-making, physicians get all kinds of suggestions—not only from peers, but also from …
How doctors can turn criticism into collaboration
What’s a dyad and how do I fit into it?
What do I do? These are the questions every new health care leader asks themselves, as I did, when they first join a dyad partnership. Although there has been much academic writing regarding leadership dyads in health care, with a macro focus on structure and accountability and implementation, there is a paucity of material on the practical aspects of a dyad …
Building trust in dyad leadership partnerships
She works for a not-for-profit health system, but nothing about what she described to me felt charitable. A young physician, just a few years into her career, she’s already facing a choice that no doctor should ever have to make: protect her patients or protect the metrics that determine her employer’s paycheck.
The heart of the problem
This physician works under a value-based payment model. On paper, it sounds great: Pay doctors …
The hidden moral injury behind value-based health care
Sepsis continues to pose a serious threat to patients and a significant challenge to hospital systems. Despite advances in awareness and clinical guidelines, delays in diagnosis and treatment remain common and costly. Sepsis is the leading cause of death in U.S. hospitals and costs the U.S. health care industry $62 billion annually.
The ripple effects of sepsis extend far beyond the bedside, impacting everything from …
The memories are still raw: Stepping off the plane alone, unsure of what came next. Where was the campus? The car? A place to live? I didn’t know a soul. I was in a different country, surrounded by uncertainty.
There were moments I truly wondered if I’d make it. I was afraid I’d fail—that this dream might slip through my fingers. How could I study medicine on a tiny island and …
From rejection to resilience: a doctor’s rise through the Caribbean route
The other day, I was deep in conversation with my co-founder, Aaron Patzer, reflecting on how we each approach health concerns in our personal lives. Despite my background in emergency medicine and his in tech, we had surprisingly similar medical information seeking habits: We both turn to large language models (LLMs), tap into our networks, and—when possible—avoid visiting a doctor.
What struck me wasn’t just our shared behavior, but how universal …
Rethinking medical gatekeeping in the age of AI
As physicians, we are trained to care—for patients, colleagues, and our communities.
When it comes to caring for our own aging parents and ill family members, most of us find ourselves overwhelmed, overfunctioning, under-resourced, depleted, and isolated. More often than not, we find ourselves assigned the caregiving role—explicitly or implicitly—because we’re “the doctor in the family.”
We think our medical training should make caregiving easier. But the opposite is true. We know …
Why physicians struggle with caregiving and how to cope with grace
When reviewing poor maternal health outcomes in the U.S., it is clear we cannot keep doing the same thing and expect to make pregnancy safe and healthy for all. A new approach is needed that harnesses the power of molecular advances to bring precision medicine to pregnancy health. Preeclampsia, one of the most dangerous complications in pregnancy, is a disorder of high blood pressure that has eluded the ability to …
How molecular discoveries are transforming preeclampsia prediction and care
We often hear the phrase “practice what you preach.” As both a physician and a patient, I’ve learned that nowhere is this more important than in how we navigate health care.
Over the years, I’ve written about the importance of collaboration between physicians and patients. But as I’ve grown older and more frequently interact with the health care system, I’ve come to believe that good care rests on four essential elements:
Why agency and partnership are vital in modern health care
“It’s not just in your head.” For people living with complex PTSD (CPTSD), these words offer more than comfort—they offer scientific truth. Trauma doesn’t just scar the mind; it reshapes the brain. But so does healing.
The hidden epidemic of CPTSD
Unlike its better-known cousin PTSD, complex PTSD often emerges from prolonged, repeated trauma—domestic abuse, childhood neglect, trafficking, emotional captivity. And while DSM-5 only nods to it, millions silently live with its …
How neuroplasticity offers hope for complex PTSD
WeightWatchers (WW) recently completed a broader financial reorganization, realigning leadership with a sharper focus on clinical innovation and women’s health, including menopause support. The reorganization includes appointing a chief medical officer to lead a more integrated, medically informed approach.
WW’s reorganization bankruptcy was driven by mounting debt and pressure from newer weight-loss therapy products, namely GLP-1 drugs like Ozempic and Wegovy. It was also impacted by a shifting landscape where traditional …
WeightWatchers shifts to value-based care with GLP-1 strategy
Rising costs are dominating kitchen table conversations across the country, and health care is no exception. In response, federal and state regulators have introduced a range of proposals to curb spending and improve efficiencies—some thoughtful, others deeply flawed. As a former emergency medicine physician and now a health care executive with over three decades of experience, I’ve seen what works and what doesn’t. If we’re serious about cost control, we …
How reforming insurance, drug prices, and prevention can cut health care costs
Benign prostatic hyperplasia (BPH), commonly referred to as an enlarged prostate, is a highly prevalent condition affecting millions of men as they age. While it is not cancerous, its impact on daily life can be significant, causing lower urinary tract symptoms (LUTS) such as frequent urination, weak stream, urgency, or nocturia.
Over the past decade, treatment options for BPH have expanded considerably. In addition to medications and conventional surgery, there are …
New treatments for enlarged prostate offer faster relief with fewer side effects
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