Physician

Why developmental and behavioral pediatrics faces a recruitment collapse

Physician
December 14, 2025

For two months I have staged testimony, written op-eds, and amplified coalition voices about the collapse of developmental and behavioral pediatrics (DBP). This piece is an epilogue, a reckoning with a specialty that once held promise but now clings to aspirational posters instead of actionable reform.

The poster problem

The Society for Developmental and Behavioral Pediatrics (SDBP) recently circulated a flyer titled Critical Outcomes in DBP. Page 2 lists “Solutions” to the …

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Valuing non-procedural physician skills

Physician
December 14, 2025

No matter the specialty, the best doctors make it look effortless and “easy.” Whether it’s suturing a jagged laceration, reading an MRI spine with multi-level degeneration, or delivering a ten-pound baby with shoulder dystocia, the most skilled physicians can handle it without breaking a sweat. But we know it took many years of training, proficiency, feedback, and improvement to master their craft.

I’m not going to argue that surgical procedures are …

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The life of a physician on call

Physician
December 13, 2025

The moon was full, the stars shone bright
I thought I’d settle down for the night
Upon my soft pillow my head got caught
Until a phone call stirred me from my foolish thought

On Friday night of weekend call
One patient had refused it all
When Pit was offered, she said, “No way!”
Internals too were brushed away.

We waited calmly, full of grace
For natural labor to take its place

And sure enough, on Sunday’s eve
After a day …

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Why physician business literacy matters

Physician
December 13, 2025

Most physicians practicing medicine today were trained to diagnose and treat patients, not to navigate one of the most complex industries in the world, an industry characterized by ever-changing payer contracts, evolving reimbursement structures, complex and sometimes mystifying coding, and challenging operational realities. Despite the lack of training, these same physicians and providers are leading multimillion-dollar businesses and are expected by their health systems to reduce costs, improve outcomes, and …

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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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The crisis of doctor suicide in Australia

Physician
December 12, 2025

This morning, I woke up to a message from a friend that he had seen on social media a colleague he went to university with had, a few days ago, died by suicide. Last week, I had an email in my inbox from a young doctor in a training program informing me four of their trainee colleagues in the last 24 months have died by suicide. The week before, my …

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Why true leadership in medicine must be learned and earned

Physician
December 10, 2025

I learned about leadership from my father as a child. My father enlisted in the U.S. Air Force (USAF) and went through basic training. He was a “slick sleeve,” no rank insignia on his shirt sleeve as an Airman Basic. It took him the bare minimum of time, five years, to be promoted to technical sergeant because of his skills in electronics. The USAF selected him for Officers Training School. …

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What is shared truth and why does it matter?

Physician
December 10, 2025

In our diverse world, where everyone sees things through their own lens, shaped by life experiences, beliefs, and facts, chasing after one absolute “truth” often sparks arguments instead of solutions. But what if we aimed for something better: a “shared truth”? This is about coming together, respecting each other’s opinions, and teaming up to find common ground that works for everyone. It’s like turning a debate into a friendly conversation, …

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Why fee-for-service reform is needed

Physician
December 10, 2025

You just saved a patient an emergency room visit with a three-minute portal message. You reviewed their connected blood pressure cuff data, saw a concerning trend, and tweaked their medication. It was efficient, high-quality, proactive care.

Your reward? Zero dollars.

Worse than that, your contribution was invisible. It didn’t count toward your productivity. It didn’t show up on a dashboard. In the eyes of our current health care system, that high-value interaction …

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The commercialization of the medical profession

Physician
December 10, 2025

The medical profession has gone through major changes from the days-past to present days. The transition from quackery to science, and from role assuming or inheriting to regulated graduate and postgraduate education.

The changes took place over centuries, but the most notable evolution in medical knowledge and training took place in the last couple of centuries and continues to evolve. Evolves may be used to describe positive as well as negative …

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Why feeling unlike yourself is a sign of physician emotional overload

Physician
December 9, 2025

Busy physicians are moving so quickly we almost never stop long enough to acknowledge the subtle ways medicine reshapes us. But every physician I’ve ever coached, including myself, can name a moment when they didn’t quite feel like themselves. Maybe it was:

  • An answer that came out sharper than intended.
  • A conversation where you noticed your patience had run thin.
  • A heaviness that you replay over and over on your …

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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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An allegory for the broken U.S. health care system

Physician
December 9, 2025

A Guide and a Seeker walk into a bar.

The Seeker says, “I’m so glad I’m here, I’ve been searching far and wide for good beer to slake my thirst, and you, my Guide, have finally brought me here!”

The Guide says, “Ah, I know just the thing. I’ll get you some Dos Equis. A merchant’s representative told me it’s the most interesting beer in the world!”

The Guide tries to order 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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Modern eugenics: the quiet return of a dangerous ideology

Physician
December 8, 2025

I’m not paranoid. And I don’t believe in conspiracy theories. But as a physician who has spent decades watching the pendulum of medical ethics swing back and forth, I can’t ignore the pattern emerging across public health and politics today. Some of what I’m seeing looks uncomfortably familiar. It looks like eugenics, not the caricature of white coats and calipers, but the quieter, policy-driven, values-encoded version that shaped America a …

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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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The inconsistent academic peer review process

Physician
December 7, 2025

I check the submission website again. And again. Sometimes in the middle of the night, I find myself refreshing the page, hoping for a small update (a new status, a change in wording, a sign that my manuscript has moved from “under review” to “decision in process”).

For early-career researchers, this waiting game is familiar. We pour months, sometimes years, of effort into designing a study, collecting data, writing, revising, and …

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Physician end-of-year reflection: Growing through challenges

Physician
December 7, 2025

Busy physicians seldom pause long enough to feel the weight or the wisdom of the year behind them.

We know the end of the year is approaching not because we’ve reflected, but because holiday coverage discussions have begun. Someone needs to work Thanksgiving. Someone has to take Christmas. Someone will miss the department party again.

You look at the schedule and realize: This year, it’s you.

And in that moment, something inside you …

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How online parent communities extend care

Physician
December 7, 2025

As a pediatric gastroenterologist with more than 10 years of face-to-face clinical experience, I can recall countless stories of parents who felt lost at sea, adrift between vague diagnoses, inconclusive tests, and unanswered questions. Medicine has its boundaries; doctors can only work within what is known. And while artificial intelligence now helps us digest vast amounts of medical data, nothing can replace the curiosity and determination of parents who take …

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