I have a confession.
For years, I thought my dog was being difficult. She won’t eat unless I’m nearby. Not in the same house. Nearby.
She’ll wait while I answer emails, put away groceries, or finish one more task. If I’m moving from room to room, she watches me instead of eating. Only when I finally stop does she lower her head to her bowl.
I’ve joked that she’s stubborn. Lately, I’ve started …
What my dog taught me about physician well-being
For much of modern American medicine, we operated with an unspoken assumption: Resources would expand to meet demand. If complexity grew, we added specialists. If volume increased, we built. If margins tightened, we layered new reimbursement strategies. That operating model now feels more like an illusion.
Workforce shortages, supply chain instability, climate disruption, and rising costs have made constraint structural rather than episodic. We are practicing in a globally interdependent system …
Overcoming resource constraints in American medicine
There is a moment in the operating room so brief it almost disappears.
Names are spoken. Roles clarified. A question offered into the air: Does anyone see something we don’t?
For a heartbeat, hierarchy loosens. For a breath, the room remembers it is made of humans. That is the moment the checklist was built for. Not because surgeons forget steps, but because under pressure, even the best of us forget how to …
The surgical safety checklist: Why silence is the real enemy
Leadership is often discussed in broad strokes: some leaders are structured and precise, while others are flexible and improvisational. But behind those visible styles lie quiet personal and generational histories, the emotional terrain that shaped how we learned safety, trust, and control. I’ve come to see that these histories profoundly influence how we lead and how we’re perceived as leaders, especially in health care, where the stakes are high and …
How your past shapes the way you lead
In some careers, your job is not something you do; it is something you are. Medicine, acting, and politics are intimate, high-visibility professions that blur the lines between personal identity and professional role. You are not just executing a skill; you are bringing your whole self into the room, exposed and accountable.
When things are going well, that visibility can feel exhilarating. You are recognized, affirmed, even admired. Your face becomes …
When your identity is your job: Why it’s dangerous in medicine
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