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What happens when your deepest religious convictions collide with a patient suffering from metastatic cancer and no miracle in sight? Medical student Jonah Rocheeld shares the raw tension between …
Why I would never compromise on withdrawing care until I saw it firsthand [PODCAST]
During a conversation between classes one afternoon at my medical school, two classmates were discussing where they planned to train after graduation. One had already mapped out a pathway toward the USMLE and residency in the United States. The other hesitated. His hesitation had little to do with grades, ambition, or even finances. It was language. The first had studied medicine entirely in English; the second mostly in French and …
How language shapes physician migration and medical training
Health care has made extraordinary progress in clinical knowledge. Diagnostic capabilities have advanced, treatments have become more precise, and predictive analytics now help clinicians identify patients at risk for complications or readmissions. Yet despite these advances, health care systems continue to struggle with a familiar challenge: Care plans that look clear inside the hospital often break down once patients return home. Medication instructions are misunderstood. Follow-up steps are delayed. Symptoms …
Closing the execution reliability gap in health care systems
As a pain management specialist, I see patients every week who feel like they have tried nearly everything. They come to me after months, or even years, of battling chronic or refractory headaches. Their primary care doctor and neurologist have already walked them through the usual first-line options, yet the pain keeps coming back relentlessly. It steals their focus, disrupts their sleep, and robs them of the simple joys in …
How pain management solves a refractory headache
A few months ago, a well-connected investor sent me a deal for a surgical device with a proprietary safety feature. U.S. Food and Drug Administration (FDA)-cleared. Strong intellectual property. Thousands of units sold. Multiple institutional backers across several rounds. The investor who referred it had taken a company to a NASDAQ initial public offering and was putting in his own money.
On paper, this was exactly the kind of deal most …
Health care investing insights from a venture capital pro
Doctor, you see only the faint visible smile
on my exterior, my hand reaches out to shake yours
as you enter the space.
But you cannot see the “me” within,
the fear, the stress, the anxiety
that circulates inside me.
These emotions swirl within,
poking and prodding,
they hang like a weighted chain
about my heart.
I guess one could say
I am an imposter,
a person in disguise.
But couldn’t the same be said of you?
I guess you were trained
to keep your …
The silent patient experience in the exam room
I sat up on that thin mattress in a nursing home. My earthly possessions were gone. The house I loved so much and worked so hard to buy, built in 1918, was no longer mine. I had taken a second job just to move out of the dilapidated trailer my husband had brought me to. I felt surrounded by poverty and hopelessness while he showed no ambition to leave. My …
A nurse’s final reflection on life, death, and regrets
Most institutional failures appear sudden. A hospital collapses under regulatory scrutiny. A leadership crisis erupts. A safety breakdown exposes systemic weaknesses that had remained invisible for years. When these moments occur, they are often described as unexpected. But in complex systems like health care, failure rarely arrives without warning. The warning signs are almost always present long before the crisis becomes visible. The challenge is that institutions often learn to …
Recognizing structural drift and institutional failure in health care
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What happens when a patient can’t afford the treatment you prescribe but is too embarrassed to say so? Health care executive Adam Cunningham joins the show to unpack the devastating ripple effects of …
Why your patient isn’t filling that prescription (and won’t tell you) [PODCAST]
One hundred million Americans carry medical debt. Research published in JAMA Network Open found that medical debt is associated with higher mortality across every leading cause of death, including suicide. A national study in the Journal of Clinical Psychiatry found that people carrying debt burden are more than three times as likely to attempt suicide. Sixteen percent of suicides in this country involve a financial crisis. I do not write …
The hidden toll of medical debt on patient health and survival
The Ruth Jackson Orthopaedic Society (RJOS) Dr. Jessi Block Courage Award is awarded annually to an RJOS member who demonstrates strength and integrity in the face of everyday obstacles. The definition of courage is “the ability to do something that frightens one” and “strength in the face of pain or grief.” Courage is a conscious choice and a willingness to confront a difficult situation. As health care professionals, we become …
How one doctor navigated orthopedic residency while pregnant
I was recently speaking with an intensive care unit (ICU) nurse, and she described a moment that perfectly captures the weight of her profession. She was managing a post-surgical patient whose vitals were quietly deteriorating. Before the monitor alarms even registered the crisis, she had anticipated the drop, prepped the pressors, and calmly updated the attending physician. Through sheer clinical vigilance, she held the fragile line between stabilization and a …
National Nurses Week needs better nursing recognition
Super Typhoon Sinlaku got the coverage it deserved, the satellite loops, the wind speed updates, the landfall reports over the Northern Marianas. Every wobble in the eye wall drew a headline. No one was talking about what was happening inside people’s bodies. I have sat with patients days after a storm passed, experiencing blood pressure that will not budge and hands that will not stop shaking, and the sky has …
Natural disaster trauma requires mental health planning
I. Intake notes
Subject presents as a high-functioning adult with a long history of academic success and an unusual number of existential questions for someone who technically has their life together. Primary characteristics include intellectual curiosity, restlessness, and a persistent suspicion that the conventional path laid before them (while impressive) might also be some kind of elaborate trap. The subject is not failing by any objective metric. In fact, the opposite …
The reluctant achiever: Navigating identity in medical training
He had just been named a partner. The youngest in the firm’s history. The first thing he said when he sat down in my office was, “I think they made a mistake.” I have heard some version of this more times than I can count, from physicians, attorneys, founders, and C-suite executives. People whose resumes would make anyone’s jaw drop, yet who live with a persistent, quiet dread that someone …
How imposter syndrome affects high-achieving professionals
Every month, thousands of physician practices receive a marketing report. It has charts. It has graphs. It shows impressive numbers moving in the right direction. And in most cases, it tells the practice almost nothing about whether their marketing is actually working. After managing paid digital campaigns for cosmetic and aesthetic medical practices, I have seen this pattern repeatedly: practices spending $3,000 to $8,000 per month on marketing, receiving polished …
The medical practice marketing metrics that actually matter
The morning my mother passed away began like any other. She was getting ready for work. She finished her morning chai and just stepped out of the shower with the sunlight filling the bedroom. There was nothing unusual about that morning that was particularly alarming. And then, in a moment so small I almost missed it, she paused and pressed a hand to her back. “I don’t feel right,” she …
Finding humanity in medicine after a sudden illness
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What happens when medical students witness dehumanization during clinical rotations but feel too powerless to speak up? Kathleen Muldoon, a certified coach and professor in medical education, joins the show to unpack why …
Silence isn’t neutrality: Why medical students can’t wait to find their voice [PODCAST]
An excerpt from Confessions of a Problem Seeker: My Lifetime Journey From Busy Brain To Loving Heart.
In his own intuitive way, with only a second-grade education, my dad knew something was not right. Just hours after peeing in a paper cup at our pediatrician’s office, the doctor called my mom at my father’s butcher shop to inform her I had juvenile diabetes (now referred to as type 1 diabetes). …
Coping with a childhood type 1 diabetes diagnosis
When ambient listening and generative AI first entered the clinical mainstream, the value proposition was simple: Reduce documentation burden and give clinicians their evenings back. That promise resonated. Burnout was rising. After-hours charting had become normalized. Health systems needed relief. And ambient documentation delivered.
But as deployments scaled from pilot projects to enterprise rollouts, the conversation matured. CFOs and revenue cycle leaders began asking a harder question: Beyond time savings, what …
The ROI of ambient AI in health care and autonomous coding
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