Physician

Why hospitals delay action on impaired physicians

Physician

May 23, 2026

The challenges in dealing effectively with this issue are compounded by multiple factors. These include an overall national shortage of physicians, particularly in rural communities, as well as being more prevalent in some specialties than others.

In addition, if an impaired physician has been a long-standing member and past leader of the medical staff, is responsible for a significant number of hospital admissions, has consistently participated in the institution’s annual fundraising …

Lifestyle, mindfulness, and the neuroscience of happiness

Kayvan Haddadan, MD

Physician

May 23, 2026

I have been gathering information about the neuroscience of happiness for over a year now, since the completion of my previous book, Legal Mind in Medicine, and decided to put a glimpse of it in an article form for the Memorial weekend reading.

Happiness stands as a central human pursuit, shaping our physical health, mental resilience, productivity, and relationships. As physicians, understanding the science of well-being offers real value. It …

Why medical training ignores the business of medicine

Santoshi Billakota, MD

Physician

May 23, 2026

We spend a lot of time talking about how broken the medical system is: burnout, moral injury, administrative overload, loss of autonomy. We propose solutions: better workflows, more staffing, policy reform, technological innovation. But there is a harder truth we tend to avoid. The overall medical training system needs an overhaul.

Medical training does not just teach knowledge and clinical skill; it shapes identity, hierarchy, and thought patterns. From the earliest …

Fragmented care needs clinical direction, not more data

Alan P. Feren, MD

Physician

May 23, 2026

Patients often assume that someone is directing their care. That there is a clinician who sees the whole picture, integrates the information, and guides what happens next. In many cases, that is not how modern care is structured. Patients move between clinicians (primary care, specialists, urgent care, consultants), each focused appropriately on a specific aspect of the problem. Each encounter may be thorough. Each decision may be reasonable. Each plan …

Telemedicine as a career, not a side gig

AIR Physician Academy

Physician

May 21, 2026

We were on a call recently with a physician who told us, almost in passing, that she’d been seeing patients on a telemedicine platform for four years. She said it the way you’d mention a hobby. Then she added, before we could say anything, that of course it was just a side gig.

She’d been doing it for four years. It was her practice.

We’ve had some version of that conversation hundreds …

How a medical investigation drives physician burnout

Jean Paul Brutus, MD

Physician

May 21, 2026

A physician receives the letter. It is short, formal, and absolute. A complaint has been filed. An investigation is underway. In that moment, something shifts. Not just professionally, but personally. The identity built over years of training, sacrifice, and responsibility suddenly feels fragile. Every decision, every note, every outcome is now seen through a different lens. What follows is rarely discussed. Not in training. Not in hospital corridors. Not even …

How physician burnout impacts modern health care

Khai Ling Tan, MD

Physician

May 21, 2026

My daughter had been home sick for three days. Not the kind of sick that keeps you in bed, but the kind that lingers just enough to keep you home, well enough to be bored. She was restless, observant, and thinking. She is 10.

Her dad stayed home with her the first day. I took the second. By the third day, I went back to work. I arranged my schedule so …

How psychological safety reduces clinician burnout

Nicholas Testa, MD

Physician

May 21, 2026

Burnout among nurses and clinicians has been a prominent topic over the past decade. The combination of regulatory requirements, higher patient demands, and leaner budgets in the shadow of coronavirus disease 2019 (COVID-19) has fueled the embers that have allowed this crisis of clinician burnout to smolder.

Simultaneously, health care systems are striving to deliver better clinical results in a world where transparency in data and public reporting is the expectation. …

How civic engagement empowers health care workers

Stella Safo, MD, MPH

Physician

May 20, 2026

For much of my career, I understood my responsibility in familiar terms: care for the patient in front of me, advocate for better health systems, and teach the next generation of trainees. I still believe that. But I now believe something else just as strongly: If we are serious about health, we cannot stop at the clinic door. We also have to show up in civic life and in the …

Why physicians miss business owner stress in patients

Timothy Lesaca, MD

Physician

May 20, 2026

The ECG was normal. The troponin was negative. The stress test was reassuring. Yet the patient in front of you looked as if he had been living under siege for months.

He was not sleeping. His blood pressure had worsened, despite medication adherence. He described chest tightness, reflux, headaches, irritability, and difficulty concentrating. He woke most nights around 3 a.m., his heart beating fast, checking an account balance, and then lay …

Why your physician guilt may not actually be yours

Christie Mulholland, MD

Physician

May 20, 2026

I was doing the dishes recently when I was hit with a stomach-dropping sensation and an unprompted memory. A negotiation I’d had years ago with my department. I had secured fair compensation for work they needed done, using the leverage I had. I walked away feeling good about it. And yet, standing at the sink with my guard down, years later, I felt a flash of guilt so unexpected it …

The referral trap: How specialization fragments care

Ann Lebeck, MD

Physician

May 19, 2026

She was already seated when I walked in. On the desk in front of her sat a large sleeve, the kind that holds imaging films, oversized and awkward, the kind that no longer fits in a folder or a binder or anywhere in a modern clinic. Beside it was a folder. Labs indexed by specialist and date. Notes from orthopedics, neurology, rheumatology, pain management, and physical therapy. Every test, every …

California opioid prescribing: What the data actually shows

Kayvan Haddadan, MD

Physician

May 19, 2026

As a physician managing patients with chronic pain in California, I’ve witnessed the tension between necessary regulations and the daily reality of helping people in genuine distress. As chairman for the National Campaign to Protect People in Pain (NCP3), I know how important it is to advocate for our patients. While foundational reviews on prescription drug oversight provide helpful context on opioids and NSAIDs (for details, refer to chapter …

Reclaiming the lost art of the physical exam

Ann Lebeck, MD

Physician

May 18, 2026

Before the imaging, the lab work, or the referral, there is a moment when the body is already speaking.

The way someone walks into the room. The hesitation before sitting down. The guarded turn of a shoulder. The subtle shift away from one hip before pain is ever described.

Medicine once placed enormous value on these observations. Observation was not separate from diagnosis; it was the beginning of it.

Sherlock Holmes famously suggested …

Time pressure in medicine narrows how we see

Ann Lebeck, MD

Physician

May 17, 2026

Medicine values speed, but patients often reveal themselves slowly.

We are expected to identify the problem, name it, code it, treat it, and move on. That process may be necessary in a pressured system, but it can also mistake a label for understanding.

A diagnosis can be useful. It can guide treatment, open access, and reassure patients. But it can also become a premature ending to a story that still needs to …

How physician therapy sparked a medical career transition

Shahrzad Rafiee, MD

Physician

May 17, 2026

I come from a generation that does not believe in therapy. Not because we do not believe it is effective, but because we believe we can handle things on our own. If things are hard, we push through. If we need help, we figure it out independently. By the time I became a physician, self-reliance was not just a value, it was my tried-and-true survival strategy. I remember years ago, …

How a Broadway comedy saved an internal medicine doctor

Ryan McCarthy, MD

Physician

May 16, 2026

“As a witness to so much sadness and pain, how do you keep from getting depressed?” As an internal medicine doctor, I have heard versions of this question for decades. And, despite a myriad of changes in my career, my answer has never wavered. And while there are many comedians and funny things, one particular evening more than any other reveals how …

The administrative burden crushing California medicine

Kayvan Haddadan, MD

Physician

May 16, 2026

Think of the entire health care system as a chess game where the goal is to achieve a healthier population by checkmating against the “darker side,” which represents disease, poor outcomes, inefficiency, and the human suffering of untreated or delayed chronic conditions like pain.

The patient should be the king: The most important piece. Everything revolves around protecting and empowering them. Without the king (patients), the game does not …
Read more…

The administrative burden crushing California medicine

Hospital room contamination is a prescribing problem

Franklyn R. Gergits, DO, MBA

Physician

May 16, 2026

Adam was twenty-four years old. He was a passenger in a car that struck a guardrail on the interstate. The airbag hit him in the face. He lost consciousness for a few seconds and was alert and walking by the time paramedics arrived.

The emergency doctor did everything right. CT scan, labs, neuro checks. The scan was uncertain enough (possible early changes after a head impact with witnessed loss of consciousness) …

Physician depression doesn’t always look like depression

Kenneth Scott Burnham, DO

Physician

May 15, 2026

An excerpt from Lifeline: What To Do After A Mental Health Crisis.

I have spent over two decades in emergency medicine. I know what a mental health crisis looks like. I know the clinical signs, the language, the interventions. I have initiated more psychiatric holds than I can count, written discharge summaries for people leaving my ER with a handful of pamphlets and a follow-up appointment I quietly hoped they …

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