Paul Dranichnikov, MD, PhD
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Latest articles
Health policy
Health care has a problem that we rarely talk about honestly enough. It is not simply a shortage of doctors. It is not simply rising costs, longer waiting lists, an aging population, or the growing burden of chronic disease. The…
Health care has a problem that we rarely talk about honestly enough. It is not simply a shortage of doctors. It is not simply rising costs, longer waiting lists, an aging population, or the growing burden of chronic disease.
The deeper problem is that we are trying to run 21st-century health care on an operating system designed for another era. Our populations are living longer. Patients are more informed, more demanding, …
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Health care transformation can’t wait for the next crisis
Physician voices
There was a time when becoming a physician meant entering a profession in which your experience was not merely appreciated; it was actively sought after. My father belongs to a generation that remembers this world. He once told me about…
There was a time when becoming a physician meant entering a profession in which your experience was not merely appreciated; it was actively sought after. My father belongs to a generation that remembers this world. He once told me about the difficult decision he faced: whether to continue as chief of staff at a primary health care center or leave and establish his own practice. The difficulty was not finding …
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Experienced physicians and patient safety defy spreadsheets
Health technology
The modern physician is no longer competing with disease alone. The new adversary is expectation: limitless, instantaneous, and increasingly shaped by algorithms. In the span of a decade, the patient has evolved. First came "Dr. Google, MD" offering a chaotic…
The modern physician is no longer competing with disease alone. The new adversary is expectation: limitless, instantaneous, and increasingly shaped by algorithms.
In the span of a decade, the patient has evolved. First came “Dr. Google, MD” offering a chaotic but empowering flood of information. Then “Dr. PubMed, MD, PhD” sharpening the curious into quasi-specialists fluent in abstracts and endpoints. Now we face the almighty “Prof. AI”: tireless, confident, and available …
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AI gave patients answers. They still need judgment.
Conditions and diseases
For decades, the digital rectal exam (DRE), the traditional "finger test," has been a routine component of prostate screening. It is quick, inexpensive, and engrained in medical culture. But the question is no longer whether we can do it. It…
For decades, the digital rectal exam (DRE), the traditional “finger test,” has been a routine component of prostate screening. It is quick, inexpensive, and engrained in medical culture. But the question is no longer whether we can do it. It is whether we should. With PSA testing, advanced imaging, and refined risk stratification, routine DRE in asymptomatic men is increasingly indefensible.
Low sensitivity and limited value
Recent studies show that DRE has …
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Why the digital rectal exam fails prostate cancer screening
Physician voices
The cold coffee cups are the least of it. They sit abandoned on desks and in reporting rooms, small monuments to interruptions, unfinished tasks, and priorities that shift by the minute. Beside them stands the inevitable glass of lukewarm water,…
The cold coffee cups are the least of it. They sit abandoned on desks and in reporting rooms, small monuments to interruptions, unfinished tasks, and priorities that shift by the minute. Beside them stands the inevitable glass of lukewarm water, another reminder that even the most basic needs are often postponed in the service of someone else’s urgency.
What is far more difficult to ignore are the sleepless nights. The anxiety …
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Health care burnout is a structural problem, not resilience
Physician voices
We are living in an era where attention, not information, is the scarce resource. And what we pay attention to (not what we claim to value) reveals the architecture of our priorities. Consider a few comparisons that, though deliberately absurd,…
We are living in an era where attention, not information, is the scarce resource. And what we pay attention to (not what we claim to value) reveals the architecture of our priorities.
Consider a few comparisons that, though deliberately absurd, tell a deeper truth. We now have more Marvel movies than major classes of antibiotics. The world produces more aspiring pop singers than there are widely used chemotherapy regimens. Strangely enough, …
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The attention economy is starving public health
Physician voices
As a physician, I encounter humanity at its most unguarded. I have held trembling hands, delivered devastating news, and witnessed emotions stripped of pretense. In exam rooms and hospital corridors, patterns emerge with unsettling consistency. Under stress, fear, or pain,…
As a physician, I encounter humanity at its most unguarded. I have held trembling hands, delivered devastating news, and witnessed emotions stripped of pretense. In exam rooms and hospital corridors, patterns emerge with unsettling consistency. Under stress, fear, or pain, humans default to self-protection. We become impatient. Defensive. Sometimes cruel. Not because we are irredeemable, but because survival instincts speak loudly when vulnerability is exposed. Kindness, by contrast, does not …
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The medical case for teaching kindness in early childhood development
Physician voices
Fifty years ago, being a doctor was like being a cross between a wizard and a rock star. People would whisper in awe when you walked by: "There goes Dr. High-and-Mighty, saving lives and curing everything from a runny nose…
Fifty years ago, being a doctor was like being a cross between a wizard and a rock star. People would whisper in awe when you walked by: “There goes Dr. High-and-Mighty, saving lives and curing everything from a runny nose to a broken heart!” My dad used to tell me stories about how he would get waved past security, cut to the front of lines, score doctor discounts, and park …
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The death of medical swagger: How physician status has changed
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