The woman sits across from me, hands folded around a list of her medications.

We review the cholesterol guidelines. I explain the evidence. She listens carefully, then says, almost apologetically, “Doctor, I know what the data says. I just don’t want to take another pill.”

There is no anger in her voice, only fatigue, the quiet exhaustion of someone who has lived long enough to know her own limits.

I pause, because this …

Read more…

The first day I walked into my residency clinic, I realized this was the part of medicine I understood the least. The waiting room was full, and every patient carried not just a diagnosis but the weight of a system already stretched thin. We learned to triage, to document, and to move quickly. But we did not learn how to lead, how to build continuity, or how to see the …

Read more…

Every week, I see patients not because they need to, but because their insurance company says they must. A patient came in recently for one reason only: Her insurer required a referral before she could see a specialist. She didn’t want to. I didn’t need her to. But we both had no choice. After a 20-minute visit neither of us needed, I did what the insurer required: document, click, submit. …

Read more…

Being a doctor is about more than diagnosing illnesses or prescribing medications. It is about more than knowing the latest research, the right drug dose, or the most effective treatment plan. Those things matter (of course they do), but they are just part of the job description.

The reality is more human, more vulnerable, and more complex.

Imagine what it is like to sit in the waiting room before your appointment. You …

Read more…

A man sat in my waiting room, heart racing—not from chest pain, but from panic. He’d been Googling his symptoms all night. Not afraid of what is—terrified of what might be. This is the anticipatory anxiety of modern medicine—a silent epidemic that strikes before any diagnosis ever does.

Patients no longer arrive with just symptoms. They bring stories already constructed. Hours of scrolling. Threads of worst-case scenarios. Algorithms feeding fear. By …

Read more…

In medicine, one surprisingly heated debate doesn’t get much airtime: Should patients call their doctors by their first name?

It pops up often on medical forums. I’ve seen long threads dissect whether it’s disrespectful, whether it undermines authority, or whether it reflects a cultural shift in how we view physicians. Some doctors insist on “Doctor” as a matter of principle—status, respect, professionalism. Me? I appreciate being called Dr. Nadelson. It reflects the …

Read more…

One of the most important—and least discussed—truths in medicine is this:

Feeling inadequate in medicine isn’t rare. It’s everywhere—quiet, lingering, relentless.

I remember starting my outpatient practice right out of residency. I had joined a large multispecialty group filled with physicians trained at top-tier institutions. Many had been practicing for decades. They were confident. Efficient. Experienced. I was still waiting on my board scores—unsure if I was even certified yet. And yet—there …

Read more…

I’ve practiced outpatient internal medicine for over a decade, joining my current group straight out of residency. Since then, I’ve watched the landscape shift—corporate takeovers, tightening regulations, staffing shortages, and endless debates over salary, documentation, and work-life balance.

And yet—I still believe in this work.

Reimbursements have been cut. Morale has taken hits. But that’s not just an internal medicine problem—it’s a health care problem. Across every specialty, we’re navigating a system …

Read more…

As we move through life, questions of identity echo through our minds—bouncing like a pinball, scattered and relentless.

Am I a doctor? A friend? A colleague? A leader? A husband? A parent? A son? These questions don’t just arise—they linger. Because every day, we’re asked to balance who we truly are with who we’re expected to be. We carry the weight of responsibility, chasing clarity, meaning, and success. We show up …

Read more…

Physicians are human. Medicine is a career—not a lifelong vow of self-sacrifice.

Yes, for some, it may feel like a calling. But let’s be clear: Choosing medicine doesn’t mean surrendering your identity forever. Times have changed. Our mindset must, too.

Working part-time, seeking balance, or transitioning into leadership, education, or non-clinical roles is not a betrayal of the profession. It’s growth. Yet these choices are too often dismissed as abandonment.

We must let …

Read more…

When I began the journey to becoming a doctor, I believed success was a destination—a finish line I’d reach if I just worked hard enough, studied long enough, and sacrificed deeply enough.

And I did all those things.

I pushed through sleepless nights in college. Carried the weight of relentless pressure in medical school. Survived the grind of residency, where time lost all meaning. I lived with my eyes fixed on the …

Read more…