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Patient advocate Richard A. Lawhern discusses the article “U.S. opioid policy history: How politics replaced science in pain care.” Richard argues that for decades, public policy on pain treatment has been driven …
Politics and fear have replaced science in U.S. pain management [PODCAST]
A systematic review was conducted following PRISMA 2020 guidelines. Databases (PubMed, Embase, Scopus, Westlaw, LexisNexis) and gray literature were searched from January 2010 to November 2025 using terms related to medical board discipline, pain management, and overreach. Eligibility included studies, legal cases, and reports on disciplinary actions, due process violations, or consequences for physicians/patients.
Findings of 1,847 records, 42 were included (28 journal articles, eight legal cases, six reports). Key abusive …
How punitive board tactics are harming pain management physicians
The schedule is already behind. It is always already behind. In a family medicine clinic on an ordinary Tuesday, I open a chart and watch an AI tool do what it was built to do: draft the note, compress the story, produce an assessment that reads clean, confident, complete. For a moment it feels like relief, the kind you learn not to trust. Then the woman across from me says, …
AI in clinical documentation: the hidden risk of automation bias
If the computer is getting more of our attention than the patient, we have a problem. It is not a small annoyance. It is not just part of the job. It is pulling clinicians away from patients, draining attention from the exam room, and quietly chipping away at the quality of clinical education. We can debate workflow, efficiency, and EHR optimization all day long. But here is what I see …
Can AI scribes give clinicians time to teach again?
As I approach the 10-year anniversary of hearing the words “I am 99 percent sure you have breast cancer,” I have many emotions: gratitude, fear, anxiety, hope. Having been diagnosed with stage 3 breast cancer in 2016, then learning it had metastasized to my liver, so stage 4, I had so many questions and so much uncertainty.
Since then, it has been a journey of self-reflection, relationship evaluation, insurance negotiations, family …
Surviving stage 4 breast cancer: a 10-year journey of hope
In lifestyle medicine, we know the script: eat better, move more, manage stress, sleep well, connect with others. Many of us know what to do. But knowledge alone does not create transformation. What does? Identity. That quiet internal voice that tells us who we are and what we are capable of. Research by Daphna Oyserman and colleagues shows that identity drives behavior …
Why immersive travel may be a powerful tool for behavior change
Everything we know about keeping people alive under pressure we learned from war. Triage was invented on a Napoleonic battlefield. Tourniquets, hemostatic dressings, damage control resuscitation, the golden hour itself. Military surgeons figured out how to stop bleeding and move casualties while the ground was still shaking, and civilian medicine inherited every lesson. The emergency department and the battlefield have always been adjacent theaters, running the same protocols under different …
Health care cyberattacks expose a critical national security failure
Every spring, millions of families across Chinese communities around the world travel back to their hometowns for Qingming Festival, often translated as “Tomb-Sweeping Day.” It is a centuries-old tradition of honoring ancestors. Highways fill with traffic. Families gather at gravesites to clean tombstones, burn incense, and leave offerings of food. On the surface, Qingming is about remembering the dead. But in many homes, the holiday quietly exposes a different reality: …
The hidden cost of long-term care policy for family caregivers
Update from Oregon Health & Science University:
Oregon Health & Science University clarifies that no decisions have been made about the Oregon National Primate Center at OHSU.
In February, the OHSU Board of Directors authorized the university president to enter discussions with the National Institutes of Health about the possibility of transitioning the ONPRC to a primate sanctuary.
The board passed a resolution to begin a six-month timeframe for the parties to develop …
Why the Oregon National Primate Research Center is shutting down
Many physicians see fee schedules, payment rates, billing codes, and pension negotiations as administrative work best left to a few elected representatives, policy experts, or government staff. However, these physician payment tariff negotiations shape how care is delivered, how practices remain viable, how new services are recognized, and how the profession sustains itself over time. They involve fee codes, billing rules, payment rates, service descriptions, pensions, compensation models, and allocation …
Why physicians must lead payment tariff negotiations
I was halfway through my first year of OB-GYN residency when I learned that my brain had been working against me my entire life. By then, I had passed licensing exams, matched into a surgical specialty, and learned how to function convincingly while exhausted. What I had not learned, and what medicine never taught me, was how to recognize when “high functioning” was actually quiet suffering. And that distinction matters, …
ADHD in physicians: Why medical training punishes neurodiversity
Most physicians know what they earn. Far fewer know what it costs to hire them or replace them. A colleague once told me in frustration, “It takes me two years to get my money back on a new hire.” I understood the frustration, but not the math. I thought of hiring the way many physicians do: salary, benefits, maybe a signing bonus. It seemed straightforward. It is not. Hiring a …
The hidden math behind physician hiring costs and recruitment
It is time to dethrone the office visit as the king of primary care physician compensation and how the work of a primary care physician is defined.
Several months ago, a reporter asked me how many patients I see in a typical day. I told her that the question should not be how many patients I see each day, but how many patients I take care of each day, a number …
Primary care compensation models: Why wRVUs are obsolete
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Medical student Umayr R. Shaikh discusses his article “The impact of CDC’s new childhood immunization guidance.” Umayr argues that recent CDC changes, moving vaccines like flu, Hep B, and meningococcal from universal …
Shift from universal to optional vaccination risks normalizing preventable disease [PODCAST]
Physicians are often described as leaders of the health care team. The language shifts, quarterback, captain, final decision-maker, but the implication is constant: someone is clearly in charge. At the bedside, the reality feels more complicated.
In every functioning system, there is a final point of responsibility, the person who answers when outcomes are poor. In medicine, that person remains the physician. We sign the charts. We carry the malpractice risk. …
Why physicians are absorbing risk, not leading
In our modern professional landscape, we are witnessing a phenomenon I call the Schism of Time. It is not just a gap in age; it is a fundamental difference in how we perceive value, and “spend” the hours of our lives.
As technology accelerates, the cadence of our work shifts. We see a friction between the “Deep Time” often championed by seasoned leaders, rooted in legacy, patience, and incremental growth, and …
The Schism of Time: Bridging the generational gap in the workplace
There are moments in life when everything you imagined for yourself fits inside a single envelope. This week, every fourth-year medical student in the United States will open the same one at the same moment. Some people scream. Some people cry. And a few people quietly realize their life just went somewhere they never planned to go. Match Day is the moment medical students learn where their futures begin. Last …
What Match Day teaches us about unexpected life paths
“Try not to work the night shift if you can.” Many physicians have said this to patients. Some have said it to colleagues. Often, we say it because we understand the science: Working through the night comes at a physiologic cost. Night-shift work is associated with weight gain, chronic fatigue, disrupted sleep, insulin resistance, and increased long-term risk of obesity, type 2 diabetes, hypertension, and cardiovascular disease. Circadian disruption affects …
The biological cost of night-shift work on circadian rhythms
As a pain physician with over 20 years of experience treating patients with chronic pain, I hear the same plea almost every day: “Doctor, it hurts, please help.”
As an author and patient advocate, I wanted to verbalize the daily reality of chronic pain.
Chronic pain affects an estimated 24.3 percent of U.S. adults (approximately 60 million people) as of 2023, with 8.5 percent (about 21 million) experiencing high-impact chronic pain that …
Chronic pain management: Balancing relief and regulation
I walked through a beautiful hallway the other day, the kind hospitals and clinics seem to favor now, polished floors, warm lighting, and old oak paneling on the walls. It looked less like a medical building and more like the lobby of a boutique hotel. At the end of the hallway sat a receptionist who was having a bad day. Or maybe she was just doing her job. She glanced …
Why modern medicine feels more like a bureaucracy than a profession
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