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Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article, “How deep transcranial magnetic stimulation is transforming mental health care.” He shares his experience with deep TMS (dTMS), …
Deep transcranial magnetic stimulation for depression [PODCAST]
We thought we had moved on from diseases like rubella. But as measles makes a comeback, rubella may not be far behind, and this time, it could harm the next generation before it’s even born. Most people today have never seen a baby born with congenital rubella syndrome, a condition that causes blindness, deafness, heart defects, and developmental delays. That’s not because it stopped happening—it’s because vaccination kept rubella from …
How declining MMR vaccination rates put future generations at risk
When I stepped away from my clinical practice, it wasn’t because I didn’t care. It was because I cared deeply—about my patients, my colleagues, and the future of medicine. I didn’t leave to escape. I left to help heal the culture that was quietly breaking so many of us.
You can love medicine and stop seeing patients. You can love medicine and change the way you see patients. Choosing to follow …
The physician who turned burnout into a mission for change
Theft, in its essence, is the unlawful taking of something valuable from another. While usually associated with material possessions, it also extends to intangible assets such as time, reputation, and emotional well-being. When authorities like medical boards or the Department of Justice (DOJ) engage in unfair practices grounded in presumptive guilt, they are not just misusing their roles but actively stripping individuals of these invaluable resources—an abuse of power that …
Time theft: the unseen harm of abusive oversight
Every ED has patients who become part of the landscape. They come in once or twice a week, for all kinds of reasons. Sometimes they have chronic medical conditions they are unable to manage. Sometimes they are on the outskirts of society due to mental health or substance abuse disorders. The ER promises a few hours of sleep in a safe place and a meal. I formed an uneasy alliance …
How one unforgettable ER patient taught a nurse about resilience
Walk into any emergency room across the country and you’ll see familiar scenes: crowded waiting rooms, overstretched resources, and overworked physicians balancing patient care with substantial administrative burdens. Against this backdrop, physician burnout remains unacceptably high (48.2 percent of physicians), with clerical duties cited as the most common cause. Many physicians also spend significant time after working hours catching up on …
The future of clinical care: AI’s role in easing physician workload
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Cardiologist and author Eric Topol discusses his article, “What super agers can teach us about longevity and health span,” which is an excerpt from his new book, Read more…
Eric Topol explores the science of super-agers and healthy aging [PODCAST]
The author of a recent article claimed that “we all lose” when an experienced physician prematurely leaves clinical medicine. Of course, it is inevitable that a clinical career will end, but whether patients and society suffer depends on what that retiring doctor does next. Increasingly, it seems, they pursue other ways to help patients and add value to the system by pursuing non-clinical careers. That’s a good thing, because:
Why more doctors are leaving clinical practice and how it helps health care
In the noble pursuit of healing, physicians, especially those in pain clinics, are increasingly caught between the growing burden of patient expectations and a tightening web of regulatory scrutiny. A recent clinical study and a related article on KevinMD converge to highlight a deeply troubling reality: Clinicians are not only being harassed by distressed patients but are also being punished by the systems meant to regulate or protect health care.
A …
Harassment and overreach are driving physicians to quit
An excerpt from Tales from the Trenches: A life in Primary Care.
For nearly four decades in medical practice, I’ve been asked countless times about the best supplements or vitamins for improving health. Despite widespread hopes that pills can unlock vitality and longevity, the truth is less glamorous and far more powerful: The single best prescription for health is regular physical activity. Exercise, not supplements or medications, is the most …
Why regular exercise is the best prescription for lifelong health
We often speak of weight as a matter of simple math—calories in, calories out. But the body doesn’t work like an equation when it’s grieving or under chronic stress. It behaves more like a survivor, clinging tightly to resources in the face of perceived danger. And in that physiological equation, cortisol—our primary stress hormone—plays a central role.
The cortisol connection
Cortisol is released by the adrenal glands in response to stress through …
When the weight won’t budge: the hidden physiology of grief, stress, and set point
Have you ever asked yourself, “Why do your patients select you and your practice for their medical care?” Most medical practices offer the same service, i.e., evaluation and treatment, at approximately the same cost, and produce similar outcomes. After all, how many ways are there to treat a urinary tract infection, diabetes, hypertension, or arthritis? Most doctors are trained to offer similar services, which typically produce identical outcomes. So, why …
Why starting with why can transform your medical practice
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Cardiologist Lauren Weber and critical care physician Jess Bunin, co-founders of All Levels Leadership, discuss their article, “Not all heroes wear capes: Sometimes they just speak up in meetings.” They reframe medical …
Why your most heroic act might be in a department meeting [PODCAST]
This past weekend, my wife and I made our way to Winnipeg, a sleepy town nestled in the Canadian province of Manitoba. The occasion? A family celebration. My niece and her husband had just welcomed a beautiful baby girl, and they insisted, almost reverently, that my wife become the godmother. It was a request we could not, and frankly, did not want to, refuse.
Winnipeg, or “Winterpeg” as some Canadians jokingly …
Life’s detours may be blessings in disguise
I’ve practiced outpatient internal medicine for over a decade, joining my current group straight out of residency. Since then, I’ve watched the landscape shift—corporate takeovers, tightening regulations, staffing shortages, and endless debates over salary, documentation, and work-life balance.
And yet—I still believe in this work.
Reimbursements have been cut. Morale has taken hits. But that’s not just an internal medicine problem—it’s a health care problem. Across every specialty, we’re navigating a system …
Inside the heart of internal medicine: Why we stay
The slow beeping of the monitor comes to a halt and someone eventually shuts it off.
Click clack.
The machines are quiet now. I take one more look at the innocent, boyish young face and wonder what kind of life he had led. I leave the room, along with the rest of the team. A hand draws the curtain closed.
Death.
Quite literally, the most final force on Earth. The permanent, irreversible cessation of …
The quiet grief behind hospital walls
Locums can be a very challenging space, at least for anesthesiologists. Environments are frequently disrupted. There is often animosity between clinicians coping long-term with turmoil and inadequate staffing, and the temporary locums who fill a gap and are often paid substantially more for their intrusion. In anesthesia, the quality of the relationship between clinician and the total environment is essential. This includes nuances of the culture, scheduling structure and expectations, …
Why peer support can save lives in high-pressure medical careers
Imagine going to a restaurant where, instead of being charged separately for your appetizer, main course, and dessert, you pay a fixed price for the entire meal. That’s the idea behind a bundled payment plan in health care. Instead of billing patients and insurers for every individual test, treatment, or doctor’s visit during a medical episode—like a knee replacement—providers receive a single, comprehensive payment for all services related to a …
Bundled payments in Medicare: Will fixed pricing reshape surgery costs?
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Pediatrician Daniel Johnson discusses his article, “From isolation to innovation: the power of learning communities in health care.” He reflects on the collaborative, case-based learning that makes medical training exciting and contrasts …
How Project ECHO is fighting physician isolation and transforming medical education [PODCAST]
For thousands of International Medical Graduates (IMGs) every year, the third week of March is defined by a single, gut-wrenching question: Did I match? The entire future seems to hinge on a single email. We spend years navigating exams, clinical rotations, and visa applications, all for a shot at a residency spot in the United States. But what happens when that email doesn’t bring good news? For many, it feels …
Why clinical research is a powerful path for unmatched IMGs
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