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What happens when a woman is diagnosed with a rare, estrogen-sensitive lung disease at 28, in her first week of residency, with no roadmap for whether she can safely …
She was learning to keep others breathing while losing her own air [PODCAST]
If anything represents the economic effects of medical malpractice, it is the following two cases. One involves a teenage mother and a major academic medical center. According to attorneys on both sides, the lawsuit is legitimate. However, its underlying merit is described as only 25.3 percent. Nevertheless, a legal strategy obscures this. The mother is 16 years old when she conceives and lives in a West African country until 17 …
The cost of chaos in medical malpractice litigation
For three months, I searched for a preceptor. I reached out to clinics, private practices, and community providers. I emailed offices, followed up, and posted in professional forums and Facebook groups. I approached the process with persistence and respect for the clinicians whose time I was requesting. Most of the time, I received no response. When I did, the answer was typically the same: not accepting students, already at capacity, …
The rising cost of clinical placements for nursing students
As a practicing pain management physician in good standing in California, I’ve observed how accusations against physicians are actively encouraged, while meaningful accountability for false or exaggerated claims is largely ignored. This creates a system that rewards a “throw mud until something sticks” strategy for financial gain by patients, insurers, and other parties. This is precisely why I wrote the book Legal Mind in Medicine to highlight the legal …
Doctors leave California over a tilted legal system
There is a sentence physicians have said for generations: “We’ll take good care of you.” It is a good sentence. Patients need to hear it, and most of the time it is said with sincerity. Yet there are moments, more now than before, when that sentence carries a second awareness alongside it. The emergency department is boarding. There may not be an inpatient bed for hours, sometimes longer. Tests, consults, …
Integrity in medicine is quietly under strain
I was eight months old when I was diagnosed with cystic fibrosis, a genetic illness that slowly damages the lungs and can affect digestion and other organs. My parents quickly learned the rhythms of it all: treatments, medications, and constant vigilance.
But here is the part people do not always expect: I still got to be a kid. I rode horses. I ran cross country. I went to college. I fell …
Surviving cystic fibrosis: a double lung transplant journey
This month, 53 medical schools committed to requiring 40 hours of nutrition education. As the physician who co-taught the first U.S. medical school class in culinary medicine, with Mike Roizen, MD, founding director of the Cleveland Clinic Wellness Institute, I am proud that culinary medicine is now taught in roughly 80 percent of U.S. medical schools. I recognize this as a genuine win. But I have watched this story before, …
Why nature-based medicine is the future of health care
When I tell other physicians that I negotiated a sabbatical from private practice, a full semester abroad with my family, followed by months of extended travel, the reaction is almost always the same. It starts with disbelief, moves quickly to calculation (“But who covered you? What happened to your income?”), and ends, more often than not, with a version of: “I could never do that.” I understand the reaction because …
How to negotiate a physician sabbatical in private practice
A patient arrives in the emergency department vomiting. Not once or twice, but repeatedly, leaning over the bedside basin, pale and sweating, clearly miserable. Between episodes, he tries to explain what happened. Earlier in the day he felt completely fine. Then the nausea started suddenly, followed by vomiting, cramping, and a cold sweat that made his shirt cling to his back. By the time he arrived in the emergency room, …
When a stomach bug is actually an atypical heart attack
The student sitting across from me didn’t think she was burned out. She had just made the dean’s list, locked in a competitive summer internship, and was running two clubs. She was sleeping four hours a night, had stopped texting friends back, and described feeling “nothing” when she opened her acceptance letter to a graduate program she had spent two years working toward. “This is just what college is supposed …
6 signs of burnout in high-achieving students
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What happens when a patient makes a reasonable, informed decision to skip a non-mandatory test and the system simply stops? Patient advocate Aaron S. Rosenberg shares how a routine dental visit became a …
He declined routine X-rays and was denied a dental cleaning [PODCAST]
A patient nods. You explain the diagnosis. You review the plan. You answer questions. You feel like the visit went well.
“Any questions?” you ask.
“No, I am good.”
They leave. And if you are honest, there is a moment, sometimes fleeting, sometimes not, where you wonder: Did they actually understand any of that? As you know, you have to pick up the pace to see another patient. In modern medicine, we measure …
Why patient understanding is the missing metric in medicine
Nursing education is at a breaking point. In classrooms and clinical sites across the country, faculty are stretched thin while students struggle to get the hands-on experiences that build confidence for day one of practice. The result is mounting pressure to expand access without sacrificing quality. Programs must graduate nurses who are technically competent and truly practice-ready, in a profession evolving faster than ever. Striking that balance with lectures, clinicals, …
Transforming nursing education with immersive technology
You know what it feels like to keep working and pushing yourself when you are tired, distracted, or maybe even burned out. It’s common across professions, and we rarely speak about it openly. We almost never think of it as a safety issue. But for airline pilots, that silence can put hundreds of lives at risk.
That is why I believe this belongs in a conversation among clinicians. Medicine is often …
Pilot mental health is a safety issue, not a stigma
I am a registered nurse with 16 years of bedside experience, and I have come to understand a problem in health care that is rarely named directly: The conditions we work under shape what we are able to perceive. Care is still delivered. The chart is complete, the discharge is placed, and the bed opens. From the outside, the system appears to function, but something essential is missing, and the …
How high pressure destroys relational care in nursing
The current U.S. Secretary of Health and Human Services, Robert F. Kennedy Jr., has consistently captured public attention with his actions and rhetoric, but one aspect of his public health agenda that has received comparatively little scrutiny is his proposed reconceptualization of addiction treatment, undergirded by his support for and stated intent to emulate Patrignano. Patrignano is an addiction treatment program in Italy where people who use drugs (PWUD) participate …
Why Kennedy’s addiction treatment plan raises ethical concerns
It started with a headache. At least, that is what she told the nurse. A middle-aged woman sat quietly in the outpatient clinic, her hands folded tightly in her lap. She had visited the hospital three times in two months complaining of headaches, fatigue, and body pains. Her blood pressure was normal. Her blood tests were unremarkable. Her physical examination revealed nothing alarming. Yet something was clearly wrong. After a …
Why mental health care in Nigeria needs a new approach
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When did volunteering stop being a choice and start being a condition of professionalism? Pediatrician, certified coach, and mindfulness and yoga teacher Jessie Mahoney realized she had donated over 2,000 hours of uncompensated …
She donated 2,000 hours of unpaid labor before she even noticed [PODCAST]
Long before I stood on collapsing bridges between DBP and NDD, I was the 1977 kid who intentionally derailed Bobby Jr.’s grand “seed money” scheme for free home heating oil for the poor, not out of mischief, but because there was no plan behind it. It was a hallucinogenic vision dressed up as strategy, with no capability for realization. Even then, I could not pretend something workable existed when it …
Bridging the gap in neurodevelopmental care and pediatrics
Imagine going to the hospital after nine months of pregnancy expecting to have a perfect birth and baby only to suffer from a tragic birth complication. Your doctor shares that your baby has a brain injury and must be transferred to the neonatal intensive care unit (NICU) for cooling treatment. You meet your baby surrounded by machines and loud monitors. For three long days during this cooling treatment, you are …
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