Julie K. Gunther is a family physician.

Beyond 5 percent quit rates: nicotine harm reduction

Conditions and Diseases
June 10, 2026

In 2021, I was asked, “If a patient is 200 pounds overweight and loses 100 pounds, would you tell them that’s not good enough?” It was a compelling question. In the words of my favorite surgical attending, we don’t let perfect be the enemy of good. We would celebrate that win, and keep going.

The next question stopped me: “Do you have strategies to help smokers make similar incremental change?”

I didn’t. …

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Beyond 5 percent quit rates: nicotine harm reduction

Physicians: Let us rise. Let us lead.

Physician
May 15, 2018

As has been much discussed in the last few years, our health care system is in crisis. We spend $3 trillion a year on Medicare. MRIs bill out at $5,000. My recent bilateral mastectomy totaled $33,000 with $800 of that actually going to my surgeon.

I left my role as an employed physician in the traditional insurance-based fee-for-service structure because I spent 80 or more hours a week typing, collecting data, …

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Physicians: Let us rise. Let us lead.

How I became the doctor I always wanted to be

Physician
December 18, 2015

I could wallpaper a rather large wall with my diplomas, certificates, awards, and licenses.  Each gilded slip of paper demarcates a moment in the last 20 years when I finished, graduated, certified or did any one of many steps required to become a board certified physician. Yet, after all of the sleepless nights, deferred self-care and catastrophic debt — after all this — 3 years ago I sat at my …

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How I became the doctor I always wanted to be