The measure of a doctor, the misery of a patient

Physician
October 3, 2025

In the grand edifice of American medicine, where the Enlightenment’s promise of rational progress once shone brightly, a shadow now lengthens across the corridors: the tyranny of the metric. Conceived in the spirit of Taylorism’s efficiency and Deming’s quality control, these numerical arbiters were meant to elevate the healer’s art, transforming subjective judgment into objective excellence. Yet, as with so many well-intentioned intrusions of bureaucracy into human affairs, they have …

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The hidden cost of a physician’s intellectual identity

Physician
October 3, 2025

My mind became the centerpiece of my identity early on in life. I lived so intimately with my thoughts that I came to believe this is who I was. As academic success and the praise of being “the smart one” set me apart, I internalized a sense of uniqueness. Others saw it too, which created early recognition… and isolation.

And here lies the hidden cost:

Pregnancy after age 35: What are the real risks?

Conditions
October 3, 2025

An excerpt from Understanding High-Risk Pregnancy: A Patient’s Guide to Prenatal Complications.

If you are 35 or older and either pregnant or thinking about having a baby, you are not alone. The average age for women having babies in this country and around the developed world has increased significantly over the past two decades, and the percentage of women having children after age 35 has increased as well. The teenage …

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Why the “Cap’n Crunch” approach to medicine puts patients at risk [PODCAST]

Podcast
October 2, 2025
YouTube video

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Patient advocate Timothy Thomas discusses his article “The Cap’n Crunch philosophy of medicine.” Timothy shares his personal experiences with gaps in primary care, from learning of his diabetes diagnosis at a Walmart …

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The Cap’n Crunch philosophy of medicine

Conditions
October 2, 2025

Cap’n Crunch never held a true naval rank; he was called “Cap’n” because he was the highest-ranking person present, not because he replaced someone more qualified. In some clinics, it is the same: the system is built so you rarely, if ever, see a real doctor. Whoever is around with the right badge simply gets the title and responsibility by default. This “Cap’n Crunch” phenomenon is not limited to one …

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Building the medical home before it had a name

Physician
October 2, 2025

In the early 1990s, while the American Academy of Pediatrics was formalizing its vision of the “medical home,” we were already living it, without a name, without a policy statement, and without institutional applause. At Minot Air Force Base in North Dakota, our pediatric team operationalized what would later be codified: interdisciplinary care, family partnership, coordinated services, and continuity across settings. We did not call it a medical home. We …

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Why doctors are leaving insurance-based care

Policy
October 2, 2025

For years, concierge medicine and direct primary care (DPC) were viewed as fringe alternatives, reserved for affluent patients or entrepreneurial physicians willing to step outside the insurance system. But in my opinion, these models are no longer “nice-to-have” side projects. They’re becoming essential pathways for physicians to reclaim careers, reduce burnout, and meet patient expectations in an evolving health care landscape.

Burnout is pushing physicians to the edge.

The pandemic only magnified …

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The surprising link between migraine and tinnitus

Conditions
October 2, 2025

Recent research has revealed that atypical migraine can influence tinnitus in some individuals. Some patients report significant improvement in tinnitus when treated with migraine-specific therapies. But how can someone know whether migraine is a factor in their tinnitus, and what treatments might help?

Understanding migraine beyond headaches

Migraine is a complex neurological disorder, not just a severe headache. Some people experience migraine without ever having a headache. It is thought that inherited …

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Rethinking the JUPITER trial and statin safety

Conditions
October 2, 2025

We have all been told the story: High cholesterol leads to heart disease, and statins are the magic bullet. The JUPITER trial, published in The New England Journal of Medicine in 2008, became one of the most heavily publicized pieces of “proof” supporting that belief. It claimed that rosuvastatin significantly reduced heart attacks, strokes, and cardiovascular events, even in people with normal LDL cholesterol levels.

But what if I told you …

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Why culturally compassionate care matters for South Asian communities

Conditions
October 2, 2025

South Asians are one of the fastest-growing immigrant populations in the United States, yet their health experiences remain poorly understood, often falling into broad “Asian American” categories that erase unique needs. The result is persistent inequities: South Asians face disproportionately high rates of conditions like diabetes, heart disease, and PCOS, while also contending with cultural stigma, language barriers, and limited representation in the health system.

As a public health professional and …

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My rare disease was my greatest teacher

Conditions
October 2, 2025

I was at one of the lowest points of my medical training. I had just finished my second-year exams. The stress had left me feeling hollow, anxious, and utterly drained. It was in this fragile state that my own body turned against me.

It started with a fever that would appear every evening. I told myself it was just the change of season. I took paracetamol and tried to ignore it. …

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Why imposter syndrome is a systemic issue, not a personal flaw [PODCAST]

Podcast
October 1, 2025
YouTube video

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Physician Jessie Mahoney discusses her article “Imposter syndrome is not a personal failing.” Jessie explains how self-doubt among physicians is less about individual weakness and more about a conditioned mindset reinforced by …

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Reclaiming the human parts of a physician

Conditions
October 1, 2025

When you step into medical training, you’re often told, both implicitly and sometimes even explicitly, that certain parts of you don’t belong. Sensitivity, doubt, or even just being messy and human can feel like liabilities in a culture that prizes efficiency, certainty, control, and always “having the answer.” Many physicians I work with in therapy describe learning early on to “toughen up,” to silence the softer, more questioning sides of …

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My journey into integrative medicine started as a patient

Physician
October 1, 2025

Twenty years ago, when I started medical school, I had no idea that this would be my path. Coming from a research background in cancer biology and biophysics, I did not have much exposure or interest in integrative medicine. My path to practicing integrative and functional medicine and incorporating new modalities to my foundation as a general internist, was not linear, and not expected.

I was pregnant twice during my three-year …

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Stepping down in medicine is an evolution

Physician
October 1, 2025

In medicine, we’re trained to stay. To endure. To prove our worth by how much we can carry and how long we can carry it. Our roles become our identities. Our achievements and labels become scaffolds of self-worth. In medicine, stepping down is often labeled as a sign of weakness. So we hold on to roles even when they no longer fuel us. We are usually still doing the job …

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The ethics of marketing unproven autism tests

Conditions
October 1, 2025

When I received an invitation to a webinar titled “Special Session on a New Autism Risk Test,” I expected a discussion on screening strategies or intervention innovations. Instead, when I researched the company and reviewed its website, I discovered a pitch for a punch-biopsy-based lab test marketed as a way to detect autism risk in newborns as early as two days after birth.

As a nurse practitioner who treats autistic patients, …

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From Tokyo to Paris: Bringing the brushstrokes of healing to Western medicine

Physician
October 1, 2025

When we think about palliative care, our first instinct is to picture pain medications, symptom checklists, and clinical protocols. But for patients with terminal brain cancer, the reality is much more complex. As speech declines, as motor function deteriorates, and as identity itself feels threatened, the greatest need is not always more medicine; it is meaning, connection, and dignity.

In recent years, I have had the opportunity to study an ancient …

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Why younger patients are now showing up with heart attacks

Conditions
October 1, 2025

Not long ago, a 36-year-old man came to the emergency room with crushing chest pain. He had no significant medical history, exercised occasionally, and thought heart disease was something he would only need to worry about decades from now. To his disbelief, he was having a heart attack.

Stories like his are no longer rare. Cardiologists and emergency physicians are increasingly seeing patients in their thirties and forties presenting with acute …

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How to spot bad science in medical news

Conditions
October 1, 2025

We often see media headlines or articles about scientific and medical advancements promising imminent treatments or cures. I am not referring to advertisements that frequently masquerade as stories for naturopathic, homeopathic, or other unproven remedies, but rather those from supposedly reliable sources, such as CBS, Yahoo, or the Chicago Tribune.

Reporters or news writers often compose them, despite lacking training in science or medical reporting. They frequently make inappropriate assumptions and …

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A psychiatrist reflects on two decades of treating depression with ketamine [PODCAST]

Podcast
September 30, 2025
YouTube video

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Psychiatrist Muhamad Aly Rifai discusses his article “A psychiatrist’s 20-year journey with ketamine.” Aly recounts his first encounters with ketamine at the National Institute of Mental Health, where its rapid impact on …

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