Psychiatry

A physician’s tribute to his medical technologist wife

Physician
December 12, 2025

At a northern U.S. Air Force base, it did not take long for the hospital administration to realize that the Red Cross volunteer in pediatrics (my late wife Kathy) was no ordinary civilian. With her two-year degree in medical technology and a bachelor’s in biology, plus board certification through the American Society for Clinical Pathology, Kathy quickly caught the attention of Capt. Humphries, the chief of the hospital laboratory.

Unlike most …

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Does medical training change your personality?

Physician
December 12, 2025

Something very distinctive happens once students complete medical school and residency: some of them start acting like excrement. Not all, but enough that most of us have witnessed the transformation. Maybe you’ve noticed it in your mentees, or in the children of friends and colleagues who went into medicine. Maybe, uncomfortably, you’ve wondered if it happened to your own children. And, if you’re like me, reflecting at the tail end …

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A doctor on high-functioning alcoholism

Physician
December 9, 2025

For decades, I practiced medicine as a dermatologist and dermatopathologist, serving patients and teaching medical students at UC Irvine. I believed I could recognize addiction when I saw it. I was always alert for signs, such as the patient whose story didn’t quite match the evidence, or whose habits hinted at something deeper.

When alcohol came up in conversation, I learned early to quietly double whatever amount the patient reported; experience …

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Understanding the cracked pot theory of a medical legacy [PODCAST]

Podcast
December 8, 2025
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Psychiatrist and author Arthur Lazarus discusses his article, “Finding integrity at the end of a career.” Arthur shares the poignant narrative of Dr. Raul Morales, a community internist facing retirement with a …

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Blackballing in medicine: a physician’s story

Physician
December 8, 2025

Medicine remembers data but forgets voices. I learned this between 1999 and 2003, when I was quietly fired and branded as someone who had “burned too many bridges.” That label was projection, not a critique of my science. My work within the national research network remains foundational to current clinical guidelines, and my training-grant application ranked near the top of all those submitted. Yet the whisper of “bridge-burning” became the …

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Telehealth stimulant conviction: lessons from the Done Global case

Conditions
December 8, 2025

The recent federal conviction of Done Global’s CEO, Ruthia He, and its clinical president, psychiatrist David Brody, on November 20, 2025, has brought long-standing concerns about virtual ADHD prescribing into undeniable focus. A San Francisco jury found both executives guilty of conspiring to distribute Adderall and other Schedule II stimulants, along with health care fraud and (for He) obstruction of justice. According to the Department of Justice, Done Global generated …

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The problem with perfectionism in health care

Physician
December 8, 2025

We work in an impossibly depleted health care system and under impossibly high expectations of perfection from society. We hold our peers, our team members, our trainees, and most of all, ourselves to rigid, lofty ideals of flawlessness. By glorifying perfectionism in medicine, we have effectively dehumanized ourselves.

The oath we take is “Do No Harm.” It is not “Try your best to do no harm.” Is it appropriate to expect …

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A leader’s journey through profound grief and loss [PODCAST]

Podcast
December 7, 2025
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Health care strategist Dana Y. Lujan discusses her article, “Grief and leadership in health care.” Dana shares her devastating personal story of losing both her son’s father and, six years later, her …

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A pediatrician’s medical service in war and peace

Physician
December 6, 2025

I was the expectant team leader at Minot, the one designated to survive “a little longer than the others” if nuclear war came. My role was not glamorous. It was a reminder that even in medicine, some of us were expendable. Years later, I was nearly sent to the First Gulf War, and I watched colleagues deployed to Afghanistan, developmental pediatricians pressed into service far from the children they were …

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Institutional inbreeding in developmental-behavioral pediatrics

Conditions
December 5, 2025

Developmental-behavioral pediatrics (DBP) was once defined by giants, leaders who authored textbooks, set standards, and gave the specialty a clear identity. Today, the field is fragmented, misunderstood, and too often hostile to new ideas. My own career arc illustrates how inbreeding and isolation have hollowed out DBP, leaving children without advocates and institutions without direction.

At a major military medical center, retired military DBPs replaced me. All were trained at that …

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A psychiatrist explains the new frontier of prescribed software treatments [PODCAST]

Podcast
December 3, 2025
YouTube video

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Nationally recognized psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article, “The rise of digital therapeutics in medicine.” Muhamad explains what prescription digital therapeutics (PDTs) are, emphasizing they are …

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How stigma in psychiatry affects patients

Physician
December 3, 2025

As a psychiatrist, I often find myself confronting not only the symptoms of mental illness but also the deep scars left by stigma. Even in 2025, despite advances in neuroscience and a growing cultural focus on mental health, stigma remains one of the greatest barriers to healing. It manifests in silence, shame, and misunderstanding, and it affects patients, families, and even those of us within the psychiatric profession. Addressing stigma …

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Developmental-behavioral pediatrics: the lost identity

Conditions
December 3, 2025

Developmental-behavioral pediatrics (DBP) has lost its identity, and my career shows what happens when leadership retreats.

When I applied for positions in Tucson and Jacksonville, I was not seen as a developmental pediatrician with expertise in neurodevelopmental disabilities. Instead, I became the dumping ground for “Stranger Things” (children whose needs were psychiatric, not developmental). Administrators and chiefs, lacking even a basic understanding of DBP, misrouted cases into my lap. The result …

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Why psychologist training takes years

Conditions
December 3, 2025

As a practicing (“licensed”) psychologist, this issue comes up frequently. What are the differences among the myriad of mental-health professionals and does it even matter? As a researcher, as well as a clinician, my first inclination is always to look at the literature when seeking answers. What have others written on whatever topic it is that I am trying to better understand? Did someone else already answer my question? So, …

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When patients self-diagnose from TikTok

Conditions
December 2, 2025

It’s a moment I’ve come to recognize too well as a psychiatry resident: a patient walks into my office already convinced of their diagnosis. They’ve watched a dozen videos, followed mental health influencers on Instagram, and taken online quizzes that “confirmed” what they suspected. They have ADHD, or autism, or borderline personality disorder. They’re not here for an evaluation; they’re here for validation.

On one hand, this moment feels like progress. …

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Imposter syndrome: a poem of self-talk

Conditions
December 1, 2025

Many of the physicians I work with live with a quiet weight of imposter syndrome. They show up every day for patients, teams, and families, yet doubt their own belonging.

I wrote a short reverse poem, “Worthy in Reverse,” as a way to explore how self-talk can shape that inner experience. This poem was inspired by “Worst Day Ever?” by Chanie Gorkin, which creatively uses structure to shift perspective.

It is simple …

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How online physician reviews impact your medical career

Physician
November 30, 2025

Have you ever wondered how a single online comment might shape your reputation as a physician? I have, especially after reading a review that sardonically suggested I had earned my medical degree from Amazon (the company, not the rainforest). The jab was clearly meant to sting. Although I regret the dissatisfaction behind it, it gave me pause. How much weight do we give these offhand remarks, and what do they …

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Divorced during residency: a story of clarity

Physician
November 27, 2025

Keeping my head down and working through intern year was all I had known. My days blurred into nights, and my weeks into months. The dreary Pacific Northwest winters had only compounded this. Despite a quiet yearning for connection and community, I declined most social invitations. My sense of obligation did not end at the hospital doors. It followed me home, where expectations and emotional responsibilities lingered. I often felt …

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The ethical conflict of the Charlie Gard case

Conditions
November 24, 2025

Some cases linger in our memory because of the humanity at their center. The case of Charlie Gard, which unfolded in England in 2017, is one of those. It took place within the National Health Service and under a legal framework in which courts decide a child’s treatment when parents and clinicians cannot agree. Before it became a global controversy, before it drew international headlines, it began as something far …

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Gen Z, ADHD, and divided attention in therapy

Conditions
November 21, 2025

Halfway through a teletherapy session, you notice your therapist pause mid-sentence. They’ve just heard the soft clatter of your keyboard, or seen your eyes flick sideways to a second screen. You’re technically “there” on video, but a work email just popped up, laundry is buzzing, someone’s messaging you, and suddenly the session is sharing space with three other tabs in your brain.

On the therapist’s end, it can feel like talking …

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