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Social media says to spike your fiber intake as fast as you can. That is where the bloating starts. Lisa Talamini is a registered dietitian nutritionist and senior vice president of clinical solutions …
Bloated from all that fiber? You added it too fast.
Physicians are trained to manage complexity under time pressure. We carry twenty patients, track a dozen pending studies, remember which consultant owes us a callback, and keep it straight. Then we go looking for a job and manage the whole thing out of an inbox and a legal pad.
A hospital-employed position search generates a startling volume of material: recruiter emails, competing time zones, credentialing packets, site visit logistics, contract drafts …
AI was the chief resident for my physician job search
Every year, families celebrate college acceptances while quietly worrying about something that has little to do with academics, roommates, or move-in day logistics. Their concern is food, and more specifically, whether their child is prepared to manage celiac disease independently in an environment that looks very different from the carefully structured routines they have relied upon for years.
For many families, gluten-free living becomes part of the household routine. Parents know …
Celiac disease in college: 3 skills to build first
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She built a thriving practice in Manhattan and appeared all over the media. Then she walked away, and it was never burnout. Samantha Nazareth is a gastroenterologist and the author of the memoir …
Leaving her practice to reinvent herself from scratch [PODCAST]
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A teacher came in for migraines and weight loss with a stack of leaky gut test results and a diagnosis that never fixed her. Shiv K. Goel is a board-certified internal medicine and functional medicine physician who argues that leaky gut is …
Your leaky gut tests aren’t fixing you [PODCAST]
This article is for those living or needing to live a gluten-free lifestyle, but still also appreciate a good guide for the grocery store too. Up to 15 percent of Western countries avoid gluten. By the year 2030 there could be up to 600 million people worldwide avoiding gluten, and those numbers could influence a buyers market of a whopping $13.67 billion.
So what is gluten in a nutshell? It’s a …
The best gluten-free Trader Joe’s finds to grab now
I spent thirty years in academic medicine as a dean for faculty affairs and development, training physicians to be not just clinically competent but genuinely patient-centered and thorough. I believed in the system I helped build. I still do, mostly. But I am also a patient. And as a patient, the system failed me for fifteen years, not through negligence, but through something quieter and harder to fix.
Fragmentation.
The history
In 2005 …
When fragmented care misses pancreatic enzyme insufficiency
When I first learned of chef and food activist Alice Waters and her farm-to-school initiative, I could see how programs that connect children to fresh local food can influence how they interact with their meal. Schools were no longer places where typical cafeteria-style lunches were served; they became places where students learned how food and health were connected.
I began to wonder why that idea stops at schools.
As a chronic disease …
Why hospital food is failing patients who need to heal
Irene came in for migraines.
Thirty-six years old. Elementary school teacher. Already diagnosed with irritable bowel syndrome. Already scoped twice, endoscopy and colonoscopy both showing diffuse inflammation, gastritis, GERD. Already told she couldn’t tolerate GLP-1 medications because of her IBS. She had done her research online and found me.
She seemed, on the surface, like a patient with a well-documented GI history and a headache problem. I almost missed what was actually …
Why your leaky gut tests aren’t fixing your symptoms
New cardiovascular-kidney-metabolic (CKM) syndrome guidance from the American Heart Association (AHA) reflects an important shift in how health care understands chronic disease.
For years, conditions including obesity, type 2 diabetes, cardiovascular disease, and chronic kidney disease have often been discussed, managed and measured separately. The newest CKM framework recognizes a different reality: These conditions are deeply interconnected, driven by many of the same underlying metabolic processes and risk factors.
But perhaps …
Stop screening for chronic disease in silos
We all saw the report on early clinical departure. Women are leaving medicine at age 45.8. A senator immediately replied that we needed to be more selective and implied that medical school applicants should accept 30 plus years in a career that is crumbling under our feet.
We know the data. Women physicians have higher burnout than male physicians, and we also know that women physicians have double the suicide …
10 ways to keep women physicians from leaving
A 22-year-old came to my office because he wanted to “get on track” with his health.
He was not in crisis. He did not feel sick. His labs were concerning, but not unusual for primary care: triglycerides in the 250s, a hemoglobin A1C near the diabetic range, elevated blood pressure and central obesity.
Then I reviewed his liver stiffness measurement. F3 fibrosis.
That result was hard to believe. Over time, it prompted me …
The liver should play a larger role in managing metabolic disease
Physicians tend to view conditions affecting mental health as entirely different from those affecting the digestive system. Depression is managed in one clinic, irritability and constipation in another, and chronic fatigue somewhere in between. However, mounting evidence indicates that these conditions are potentially interconnected. The connection might start in the gut.
Human intestines are host to trillions of microorganisms collectively referred to as the gut microbiota. They are involved in a …
The gut microbiome and mental health are interconnected
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For the longest time, indwelling balloon catheters have been the norm in the care of ICU patients. They are often used to help nursing staff keep high-acuity patients clean, manage fecal incontinence, and curb breakdown of skin. Initially, they have been seen to be a useful and reliable solution for problems related to fecal incontinence (FI).
But in oncology ICUs, their use brings up an important question that is overlooked: Are …
The balloon catheter bleeding risk no one talks about
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What happens when a Division I athlete loses 40 pounds, can barely form sentences during practice, and keeps hearing from doctors that it might just be anxiety? Kamiah Gibson, a D1 women’s volleyball …
I ate plain rice and chicken for six months because no one explained celiac [PODCAST]
Prologue
As a practicing gastroenterologist for more than 50 years, now emeritus, I was privileged to have had colleagues with expertise in many specialties to whom I could refer patients. Since my career began, the constellation of these specialists has increased considerably. Patients often find themselves moving from one “ologist” to another, each very skilled but focused on a particular organ system. From the patient’s perspective, maneuvering through the complexities of …
A humorous parody of medical specialties and the modern patient
For years, the conversation about board certification has centered on fairness, cost, and evidence. But there is another consequence that gets far less attention: how these systems affect the supply of practicing physicians.
America’s physician shortage isn’t theoretical anymore. It is here. Hospitals are scrambling to fill call schedules, rural communities are waiting months for specialist appointments, and medical groups are watching senior clinicians retire earlier than planned. Among the many …
How board certification fuels the physician shortage crisis
“The only thing that will change will be our name.”
These were the words shared by a senior partner when our staff was informed that the partnership had decided to sell the practice to a private equity firm. Unfortunately, as the story unfolded, that was also the moment that my future changed.
I was an associate when those now infamous words were uttered. While I was wary of this transition, it was …
“The only thing that will change will be our name”: a private equity cautionary tale
If you asked ten physicians to explain how they maintain board certification, you’d get at least ten different answers, maybe more. Some take quarterly quizzes. Some submit CME attestations every five years. Some do both. Others, grandfathered in before time-limited certification existed, do nothing at all. Yet every one of them carries the same professional label: board-certified physician.
That simple title, once synonymous with competence, now hides a dizzying patchwork of …
Why maintenance of certification varies widely: a system in crisis
After I got diagnosed with celiac disease when I was 19, I faced a difficult choice every time friends invited me out: I could either stay home, or I could risk getting terribly sick.
I was a college volleyball player at West Virginia University when I started experiencing severe migraines and stomach issues. I could not eat anything without getting sick, which resulted in me losing 40 pounds in just two …
Managing celiac disease: Overcoming the hidden social burden
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