When I started practicing medicine more than thirty years ago, I believed the system was imperfect but noble. We worked hard, we cared deeply, and I thought that if we just kept doing our best, things would gradually improve. I trusted that technology, new policies, and better organization would eventually bring us closer to the ideals of medicine. Some of those changes helped. Many did not.
If I am honest, there …
He was five, wiry, and fast, so fast his mother looped her purse strap around his wrist in the waiting room. She spoke softly, in Spanish, explaining that he could not sit still, could not sleep, could not stop. As she described his meltdowns, he interrupted with nonsense sentences, unrelated to her words, untethered from context. It was not defiance; it was overflow.
I and my team of CNA Spanish interpreters …
I just spent a weekend doing absolutely nothing. Well, nothing memorable, anyway. The week before, I’d been on home call during an Epic upgrade. If you’ve lived through one of these updates, you know the chaos. In addition to the usual phone calls about echo results, arranging studies, and communicating with referring physicians, I was getting a constant stream of secure chat notifications updating me on the system’s progress. These …
The 9/22 White House press conference regarding acetaminophen raises two serious concerns. First, the scientific accuracy of the purported link between acetaminophen and Autism Spectrum Disorder (ASD) is dubious. Additionally, the norms of public communication concerning whether a President should offer medical advice existed for good reason. The heads of CMS, NIH, and FDA were present, but did not dispute in real time the essential claim that Tylenol causes autism.
Second, …
In the early 1990s, while the American Academy of Pediatrics was formalizing its vision of the “medical home,” we were already living it, without a name, without a policy statement, and without institutional applause. At Minot Air Force Base in North Dakota, our pediatric team operationalized what would later be codified: interdisciplinary care, family partnership, coordinated services, and continuity across settings. We did not call it a medical home. We …
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Internal medicine-pediatric physician Chrissie Ott discusses her article “When the pediatrician is the parent: a personal reckoning with childhood obesity.” Chrissie shares the deeply personal story of her own child’s struggles with …
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Physician-scientist Diego R. Hijano discusses his article “How humor builds trust in pediatric oncology.” Diego shares how personal loss and his own cultural and linguistic experiences shaped his approach to care, teaching …
The vow was not ceremonial. It was lived.
We were in Waverly, Ohio on 9/11, a town that did not make headlines, but held its own kind of gravity. The clinic was open. Kathy was chasing after Robert, age 8, who had darted toward the library at the end of the street, eager to explore its corners before school resumed. She did not call him back. She followed. That was the …
A dangerous truth is hidden behind the winning smiles and cartoon-adorned walls at pediatric dental offices: Children are dying or suffering from debilitating neurologic injury during routine care, and few are paying attention. This glaring oversight in ambulatory pediatric dental care is concerning not only for the potential harm to vulnerable, unknowing families but also to the medical community at large. Now more than ever, pediatric dental care is being …
The desegregation bus crash
I was nearly killed in a desegregation bus crash. They called it progress, but it felt like degradation. We were children, packed into metal boxes and sent across neighborhoods like test subjects. The crash was more than metal and blood, it was a system shattering itself. I survived, and I have spent the rest of my life making sure no child has to survive reform just to …
I have been a pediatrician for over two decades. I have seen trends come and go: juice boxes demonized, co-sleeping debated, and screen time limits revised. But nothing has reshaped the pediatrician-parent relationship more profoundly than one thing: the internet.
These days, I do not just answer questions; I navigate a misinformation minefield.
It is common now for parents to walk into my exam room not seeking guidance, but ready for a …
Although locum tenens in medicine has a rich history dating back to the 1970s, many misconceptions and questions continue to foster apprehension in those considering this alternative form of practice. While some view locum tenens providers as unstable wanderers who may have difficulty holding traditional permanent employment, many, such as myself, have taken this intentional path in search of independence and freedom.
From a busy metropolitan hospital in California to a …
“What is your favorite homemade food?” I ask each patient. Almost always, there is a smile, and the conversation takes off from there. Moms light up describing their special dishes. Patients giggle when I suggest, “Should we have your mom make some for us to share?” Younger kids look at their moms with wide eyes, wondering if it could really happen. Those moments, those faces, are priceless; and they carry …
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Pediatrician and certified life and weight coach Karla Lester discusses her article, “An effective treatment using an effective care delivery model: Using telehealth to treat adolescents with obesity with GLP-1 medications.” She …
Each year, I leave behind the electronic health record, performance metrics, malpractice fears, and the ever-present hum of burnout—and lead a medical mission trip—this year to Nicaragua. Along with a team of fellow volunteers, I carry only what we can pack: a few stethoscopes, essential supplies, and the will to serve.
We set up clinics in makeshift church halls with tin roofs in …
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Physician coach and medical school professor Kathleen Muldoon discusses her article, “How motherhood reshaped my identity as a scientist and teacher.” She explores what it means to be a “mother scholar” in …
Sickle cell disease (SCD) is frequently referred to as an invisible disease and is often overlooked due to a lack of research and overall resource shortages resulting in substandard clinical care. Part of the problem is difficulty objectively identifying SCD characteristics due to lack of laboratory markers and poor objective pain indicators. This disease mainly affects African American populations. Systemic marginalization of stigmatized populations results in less funding; and therefore, …
“Dr. Who?” the child asked.
“Dr. Hijano,” I said. “But you can call me Dr. Diego. Like Go Diego Go! Dora the Explorer’s cousin, the one with the baby jaguar who saves the rainforest.”
A pause. A smile. And just like that, the ice broke. In pediatric oncology, that is no small thing.
I work in a pediatric cancer center, most often in the bone marrow transplant unit. When people hear this, they …
For years, I didn’t realize the name for what I was experiencing as a primary care pediatrician was burnout. I just thought I wasn’t enough—not good enough, not hardworking enough, not experienced enough. That self-doubt didn’t stay confined to my role as a doctor; it crept into how I felt as a parent, a spouse, a community member.
Nothing ever felt like enough. So I did what I was trained to …
When I first saw the CDC’s MMWR latest report on obesity medication prescribing for adolescents, my initial reaction was probably the same as yours: less than 1 percent of teens with obesity got these medications in 2023? That seems pretty dismal.
But then I took a step back and looked at what this data is telling us. And honestly? We’re missing the real story here.
We’re witnessing something historic.
Think about where …
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