The first rule of being a doctor is not “do no harm.” It’s “mind your own business.”
You won’t find it in the ethics textbooks. It’s not part of any formal curriculum. But ask around—quietly, privately—and most seasoned clinicians will tell you the same thing: the people who ask too many questions don’t last long.
You learn this not from lectures, but from observation. A colleague flags a safety concern. A note …
The next major health epidemic in the U.S. will not come from a pathogen. This plague has a potential patient population in the tens of millions, limited effective treatments, and is not widely studied in the medical community.
I’m referring to sports gambling, an activity that deeply alarms me as a physician who specializes in addiction. Problem gambling can increase the incidence of depression and anxiety and can lead to bankruptcy, …
When I was working full time in emergency medicine, I didn’t think much about the systems in my personal life. I had just enough clarity to show up for the next shift, keep my kid fed, work out, stay married, and try to remember where I parked the car. I wasn’t stupid. I wasn’t lazy. I was underwater. So I did what a lot of physicians do when they’re trying …
The solution to the physician burnout crisis isn’t more diagnoses or interventions. The antidote isn’t more modules, surveys, screenings, or questionnaires. What’s needed is cultural healing: One that we have so far been unwilling and/or too depleted to attempt.
Over the past decade, physician wellness has been medicalized. We’ve absorbed it into the very system that made us unwell. We’ve labeled it as pathology—when in fact, it’s a predictable outcome of …
“Some people learn. Some don’t.
For the former, growing old is a joy.
For the latter, it is hell.”
I’ve seen both.
In exam rooms, break rooms, ORs, and coaching sessions. One physician softens—more present, less defended. Another hardens—brittle, often angry.
The difference isn’t intelligence, training, or temperament.
It’s whether they’re willing to learn—not just from books or trials, but from life itself.
What happens when physicians refuse to learn
Medicine does not require emotional growth to function. …
Disclosure: This should not be considered as evidence-based mental health literature. These are the observations of a surgeon with extensive experience being angry.
Introduction
Many physicians are finding themselves strained from ongoing sociopolitical crises. Dealing with the frequent or continuous consequences of unsustainable practices in health care systems, global systems issues like racism or sexism, or other large problems that are difficult to impossible …
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Anesthesiologist Maire Daugharty, who expanded her expertise by earning a master’s degree in clinical mental health counseling, discusses her article “Why ADHD isn’t just a childhood disorder and what that means for …
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Licensed clinical psychologist and health care ethicist Jenny Shields discusses her article, “DSM-5 doesn’t name it, but moral distress is everywhere in medicine.” Jenny illuminates the pervasive issue of moral distress among …
What is the purpose of psychotherapy? What are the goals?
Psychotherapy is a talking process between a patient and a psychotherapist that involves looking at feelings, behaviors, impulses, and thoughts through a process of self-reflection. The purpose of psychotherapy is to explore life patterns and to learn what works and what gets in the way of feeling successful and fulfilled. The goals are to reach one’s fullest potential. This is done …
Administrative violence in medicine is often understood as harm to patients due to systemic issues; however, administrative violence in medicine is also a process used to inflict harm on physicians, destabilizing the medical field on both systemic and individual levels. While much attention is given to how institutions and governments perpetuate administrative violence, it can also be enacted by individuals toward individual physicians with great harm, particularly by other physicians …
I remember the first time I was shamed for asking a question. It was during my OB/GYN clinical rotation in PA school. I asked my attending physician something about a patient, not out of laziness, but because I genuinely needed clarity. But instead of guiding me, he shut me down. “You should be doing your research. You should be telling me about the patient, not the other way around.” I …
Gaslighting manifests in many forms. The most common may be political fights involving the extreme positions on any controversial issue (e.g., gun control, abortion, immigration, you name it). One extreme faction claims they have the truth and blames the opposing extreme faction for the problems in our world. We see this every day in news reports. Those who have experienced gaslighting know that political fights involve gaslighting on steroids.
Another common …
In medicine, we were taught to value humility over pride. To downplay our successes. To “just do our job.” Even as we achieve remarkable things, we rarely pause to acknowledge them, let alone celebrate.
Pride feels risky. Many physicians worry that being proud means being egotistical, self-important, or inconsiderate of others who may be struggling. We were trained to attribute our successes to the team, to luck, or hard work—never to …
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She whispered when she said “panic attacks.”
Not because she thought I would judge her or fail to understand. But because she was a physician, and in her world, saying the wrong thing to the wrong person could cost her everything.
She found me through a colleague of a colleague. No insurance, no documentation trail, no diagnostic codes, no third-party systems. She paid in cash. She never used her full name.
“If I …
In medicine, we’ve long relied on the oxygen mask analogy to justify self-care: “Put your own mask on first before assisting others.” It’s a powerful image—but it’s not enough.
Oxygen masks drop in emergencies. Putting them on is a reactive action. They keep us alive—but they don’t help us thrive.
For many physicians, the oxygen mask has become the gold standard of wellness. In a culture that rewards self-sacrifice and martyrdom, “putting …
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Health care executive Traci Sweet discusses her article, “The role of contingency management in addiction treatment.” She makes a compelling case for the increased use of contingency management—an evidence-based approach utilizing positive …
We were taught that sacrificing ourselves is noble. That resilience is enduring. And that suffering and struggling are valiant.
We were taught rest is optional, complacent, lazy—something for other, less busy, less important people.
We were also taught to see “self-care” as somewhat indulgent.
Self-care is often thought of as something earned. A guilty pleasure.
Even the words commonly used in medicine to describe caring for ourselves—”self-care”—sound indulgent.
“Caring for ourselves as well” is not …
Lose weight and you’ll be happy,
They say …
I wasn’t happy,
I was exhausted and depleted.
You’re so disciplined,
They say …
As I starved myself
And had to earn my food.
I wish I could have your problem,
They say …
Brainwashed into thinking,
Smaller is better.
How do you always eat so “healthy”?
They ask …
While my list of “safe” foods
Grows shorter and shorter.
As I dream of being free
And escaping the prison in my mind …
They wonder how to be …
Here in the Midwest we have finally made it through the doldrums of winter, which also indicates the season that basketball fans eagerly anticipate all year: March Madness.
The annual National Collegiate Athletic Association (NCAA) single-elimination basketball tournament inspires millions of folks to fill out brackets predicting the winners, myself included. I love sports for a multitude of reasons, and witnessing these young adults experiencing some of the best—and hardest—moments of …
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Practicing internist and psychiatrist Muhamad Aly Rifai discusses his article, “How America became overmedicated—and what we can do about it.” He raises concerns about the high rate of psychotropic medication use in …
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