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Hematologist-oncologist Khushali Jhaveri discusses her article “What the research really says about infrared saunas.” Khushali shares her personal journey from skepticism to advocacy after experiencing the profound physiological shifts of infrared heat …
Heat therapy activates proteins that repair cells and protect the heart [PODCAST]
I have spent years watching the development of quality programs. What began as a way to ensure patient safety has gradually given way to an independent group of individuals whose job it is to interpret regulations and monitor those interpretations. In the process, the clinical richness of medicine has been lost. Judgment, narrative, and context matter less than forms and metrics. The work has shifted away from the bedside and …
The 9 laws of health care quality: Why metrics miss the point
Human milk contains more than nutrients; it carries a quiet, evolutionary intelligence expressed through chemistry. It is not conscious thought, but the slow wisdom of evolution written into molecules that nourish, protect, and guide.
Among its most remarkable ingredients are the human milk oligosaccharides (HMOs). These complex sugars, present at around 0.5 to 1.5 g/dL, are not there to feed the infant directly.
They move through the stomach and small intestine largely …
The evolutionary intelligence of human milk: HMOs and lactose
Imagine a patient who spends most of a therapy session talking about a single memory. He describes sitting in his car after visiting his mother in a nursing home, unable to start the engine. He sits there for nearly 20 minutes, staring at the steering wheel and wondering when the roles had reversed, when he had become the parent and she the child. Nothing dramatic happens in the session. No …
The hidden risks of AI-generated progress notes in psychotherapy
You probably weren’t thinking about AI the last time you sat in the dental chair. You were wondering whether that shadow on the X-ray meant a cavity, and whether it would hurt. But AI was quite possibly already at work behind the scenes, and it’s about to play a much bigger role in your next visit. As a general dentist, I’ve watched the conversation about AI in medicine grow louder …
How AI in dentistry is changing your next checkup
Life begins, and life ends.
We know this
the way we know the sun will rise,
as a fact, not a feeling.
Those we cherish
and those who cherished us
leave without rehearsal,
no warning bell
to soften the blow.
As if the heart
could ever be trained for absence.
They were threaded into the ordinary,
morning light, evening quiet,
the familiar rhythm of breath and belonging.
We assumed their nearness was permanent,
the way we assume tomorrow.
There were shared breaths of laughter,
tears that needed …
Grief and healing: Learning to live with absence
I worry about whether I can access a building much more at my current weight of 160 pounds than I did when I weighed 378 pounds.
My adult weight, until recently, averaged 300 pounds. But in early 2022 I weighed 350, and in 2013 I weighed 378.
At those weights, I worried about distances, the number of stairs, the width of doorways, and the strength of the furniture. Today, I still worry …
I lost 218 pounds and my ability to walk: a bariatric surgery regret
When I started working the night shift as a nocturnist straight out of residency, no one prepared me for the physical and mental toll that lifestyle would take on my body. My motivation for pursuing this job opportunity was to spend my daytime hours with my young children: twin boys and my daughter all under five years old.
Night shift work keeps hospitals running, cities safe, and essential services moving while …
Night shift health tips: How to protect your circadian rhythm
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Intensivist Cristin Mount and business operations lead Steve Lettrich from All Levels Leadership discuss their article “A 6-step framework for new health care leaders.” The authors address the common challenge where clinicians …
How to master a new health care leadership role [PODCAST]
During my second year of medical school, I resumed my long-standing hobby of running in an effort to stay physically strong and mentally reset. I enthusiastically signed up for a training program to run my first 10K. In the 12 weeks that followed, I discovered that the process of training to become a runner and training to become a physician share many similar pulses.
The uncertain feeling of readiness
Week one of …
Medical school endurance: lessons from training for a 10K
Could it be that it is not market forces that have distorted medicine but actually the fault of those who should have been integral to the evolution of the health care system, physicians? The industry has evolved based on circumstances. Government intrusion with unregulated bureaucracies and the poison of politics can now be described as the monopsony that is basic to the present market distortions. When pricing is arbitrary based …
Health care market distortion: How government intrusion hurts medicine
As a practicing physician who has worked in the health care field in five different countries, I have a pretty solid idea of why health care in the U.S. is so problematic. In the U.S., many entities related to health care are owned by the same companies. This is a concept called vertical integration, where one business controls every stage of the supply chain. To understand this, imagine the car …
The dangers of vertical integration in health care
I play Go. Not chess. Not checkers. Go: the ancient strategy game where the objective is not to capture pieces but to claim territory. In chess, you attack. In checkers, you jump. In Go, you place. Each stone lands quietly. Each position builds on the last. The opponent is still arguing about three moves ago while the board is already decided. The board has been built one placement at a …
Securing physician autonomy with employer-sponsored direct primary care
Most medical experts in medical malpractice are influenced by bias. Yet, they produce a certificate of merit. There are many types of biases, but I concentrate on only those biases that represent a systematic distortion that directly undermines the reliability of certainty in data and are measured by Type I and Type II errors.
Under this circumstance, merit can be regarded as certainty minus those biases. Those biases are selection bias, …
The mathematics of merit: Quantifying bias in medical malpractice
The overhead call still feels wrong when it happens on a psychiatry unit. Code blue. The words echo through hallways designed for containment and calm, not cardiac arrest. Psychiatry is supposed to be about listening, de-escalation, and meaning-making. A code blue interrupts that narrative abruptly, reminding everyone in earshot that bodies, not diagnoses, ultimately set the terms. What struck me most was not the urgency of the response (clinicians are …
When a code blue happens on a psychiatry unit
Medicine is a field defined by constant evolution. Advances in technology, groundbreaking research, and shifting patient expectations continually reshape the landscape of health care. As physicians, we are entrusted with providing excellent care. But we must also ensure that our knowledge, skills, and approaches remain at the forefront of this ever-changing environment. Staying up to date isn’t just a professional obligation, but a necessity to remain effective and relevant in …
Medical relevance and evolution: Why physicians must reinvent themselves
I switched beta blockers a few days ago. Four or five, maybe. Nothing dramatic. No crisis. No near-miss. But my fingers are warm again, for the first time in months. And I’m sleeping better than I have in a long time. Those aren’t headline outcomes. They’re not the things medicine congratulates itself for. They are just noticeable. Modern medicine is very good at preventing death. It’s less good at noticing …
Why quality of life in health care is often overlooked
I hold medical licenses in multiple states. As a teleradiologist, I have to; it is the nature of the work. What I did not fully anticipate was how much time I would spend navigating the patchwork of continuing medical education (CME) requirements that vary significantly from state to state.
The variation in numbers
In Montana, the state requires exactly zero hours of CME for license renewal. Drive across the border to Washington, …
Navigating the patchwork of CME requirements by state
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Double board-certified obstetrician-gynecologist and reproductive endocrinology and infertility specialist Erica Bove discusses her article “A clinician’s guide to embryo grading in IVF.” Erica breaks down the complex metrics used to evaluate embryo …
Understanding the science behind embryo grading improves IVF decision making [PODCAST]
Most clinicians can recall a visit that technically went well, and still didn’t feel finished.
The history was taken. The exam was appropriate. High-risk diagnoses were reasonably excluded. The plan followed guidelines. The note was clean. The visit ended on time.
And yet, something lingered. Not alarm. Not guilt. Something quieter and more familiar.
We rarely talk about this state in medicine, even though we encounter it daily. We have names for missed …
Unfinishedness in medicine: When a good visit feels incomplete
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