In the shadowed corridors of America’s great academic hospitals, those bastions of progressive piety nestled in sanctuary cities like Denver, New York, Chicago, and San Francisco, a quiet usurpation unfolds. For decades, as a physician committed to mentoring Black Americans, I have viewed my profession not merely as a vocation but as a form of restitution: a personal reckoning with the sins of our white forebears, whose legacy of chattel …
Commercial airline pilots are required to retire at 65 under Federal Aviation Administration regulations. It’s not ageism; it’s safety. Yet physicians, whose decisions can be just as life-or-death, face no such requirement. As a former internist, chief medical officer, and hospital CEO, I have seen what happens when physicians practice past their prime. The results can be dangerous, heartbreaking, and entirely preventable.
When “going out on top” doesn’t happen
During my tenure …
An excerpt from Born to Heal: Medical Narratives Set to the Soundtrack of Classic Rock.
Dr. Raul Morales sat alone in Exam Room 3, now used for storage, staring out at the fading autumn light through a slit in the blinds. The clinic was quiet, eerily so. His last patient had left an hour ago. He was supposed to be packing up his …
Each academic year, I have watched as a new class of residents and fellows prepares to graduate and launch their medical careers. They step out of the structured training environment into a professional world that is exciting, expansive, and, for many, overwhelming. Clinically, they are well trained. But residency rarely prepares physicians to recognize and advocate for what they truly need to thrive in practice. The data reflect this gap. …
An excerpt from Whispers of the Mind: A Neurologist’s Memoir.
I have never been one to seek out medical care, as I have been fortunate to have been in excellent health most of my life. So, when I presented to my GYN for my yearly follow-up, I brought up my first health complaint in the twenty years I had been seeing her, abnormal bleeding. We were colleagues and she knew …
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 …
As an academic trauma surgeon and intensive care physician, I have spent decades honing my clinical skills and teaching them to others. The recent milestone reached by Microsoft’s new AI system, the MAI Diagnostic Orchestrator (MAI-DxO), is a reminder that the cognitive frontier of medicine is shifting, not gradually, but in leaps. MAI-DxO reportedly diagnosed complex cases from the New England Journal of Medicine with eighty percent accuracy, compared to …
Emergency medicine has evolved far beyond what its founders envisioned. Once an afterthought of the health care system, it is now the gateway to care for millions. Every day, our emergency departments serve as the front door of the hospital and, for many, the only door into health care.
This is why I argue that emergency medicine safeguards human rights.
Consider the patient mix of any emergency department: we care for the …
“I was excited to see you today because I thought you were going to answer all my questions,” a patient once told me. I smiled, masking the insecurity. “I wish I could.”
The truth is, I often cannot (at least not in a single visit). Medicine is rooted in curiosity and lifelong learning. Patients expect certainty, but doctors live with uncertainty. We know enough to know how much we do not …
Let me just start by saying: If you are reading this and thinking, “Who voluntarily takes medical board exams at 63?” You are absolutely right. Normal people do not do that. They take up golf from the Green tees, try to marry off their kids, and complain that the younger generation cannot drive. But me? I spent four precious months of my remaining life cramming for the ABIM boards like …
Appointments booked months out. Overwhelmed specialists. ERs struggling to stay staffed. The physician shortage is not coming. It is already here.
The Association of American Medical Colleges projects a shortfall of more than 124,000 physicians by 2034. But that number does not capture the reality that doctors are leaving medicine quietly, every single day. Some retire early. Others step into nonclinical roles. Many more are simply trying to find a better …
In recent years, American politics has witnessed a disturbing rise in conspiracy-driven health narratives that undermine science and public safety. Among the most vocal proponents of anti-vaccine rhetoric has been Robert F. Kennedy Jr., whose campaign of misinformation poses a clear threat not only to childhood immunization but to medical research more broadly. One might assume that the nation’s leading physician organizations, particularly major medical and pediatric associations, would respond …
When I am sued by a prominent medical malpractice plaintiff attorney, I open the firm’s website. Despite the lawyer’s prominence, the website uncharacteristically solicits for medical malpractice, claiming, “If you have a phone, you have a lawyer.” We all know that it takes more than a phone; it takes a case. What I have learned since that day is a lesson for every physician practicing medicine because each, like it …
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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 urgency epidemic
I was in my office at 8 p.m. about a year ago. My back was hunched, phone in one hand and papers in the other, with twenty open tabs glaring at me from two adjacent monitors. I heard a nearby door shut and wondered, “Why is my colleague leaving so late?” Then it hit me: Have I thought of leaving yet?
If you asked me what I was doing …
The brain is a pattern-seeking organ that continually organizes the world into a more predictable experience. Our first predictions arise out of early childhood and are predicated on messaging from primary caregivers. These are deeply buried in implicit memory meaning that much of what we anticipate from interactions lies outside of our awareness. Over the course of a lifetime, these guiding assumptions working in the background are continuously modified in …
The first time I watched One Flew Over the Cuckoo’s Nest, it stayed with me for days. As an internist who has had the opportunity to care for psychiatric patients, I could not watch it as just a movie. I saw the familiar faces, the emotional extremes, the silent battles between care and control. And I felt the weight of questions the film still asks us today: Are we truly …
Modern medicine is failing in three critical areas: mental health, chronic disease, and prevention at the cost of trillions of wasted dollars and untold suffering.
The problem runs deep. In my earlier KevinMD post, “Medicine’s mental health crisis: why the system is failing us,” I described the “mind-body split” theory of the 16th and 17th-century Scientific Revolution as guiding medicine and medical education since that time. It …
Lifestyle medicine is now a known, respected and utilized aspect of medical care to help patients live healthier lives and ward off chronic disease. Clinicians often counsel their patients on the pillars of LM: movement, nutrition, sleep, stress management, connection, and avoiding risky substances. These pillars are powerful and proven to be effective. But after integrating my training as a physician and health coach to lead group wellness travel adventures …
We are trained to move quickly. To respond before thinking. To act before doubting. To rise at three in the morning because someone’s life might depend on it. That is how we learn ethics, not in seminar rooms, but in corridors that smell of antiseptic and coffee, under fluorescent light, beside stretchers with failing hearts.
And so, somewhere along the way, we begin to believe that morality lives in the moment. …
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