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Up to 40 percent of infertility cases involve combined male and female factors, but the male partner is often skipped. Erica Bove, a reproductive endocrinology and infertility specialist, returns to discuss why that gap exists and what can be done about it. …
Low T treatment is silently destroying sperm counts [PODCAST]
To this day, I still don’t remember the car accident that changed my life. It was Thursday, August 8, 2024, a day like any other. I had gone to my local gym for an afternoon conditioning class. I finished hot and sweaty, grabbed my things, and walked toward the door. That’s the last thing I remember.
The next thing I’m aware of, I’m in a hospital bed, mid-conversation with a doctor. …
The delayed brain injury symptoms I almost ignored
Our culture mythologizes the lone genius (Edison, Einstein, Jobs), systematically erasing the collaborative ecosystems that made their contributions possible. This tendency has had profound consequences. It has contributed to a century-long devaluation of the generalist, the integrative thinker who ranges across domains, synthesizes disparate knowledge, and holds the whole in view while others tend the parts. This essay traces that arc and argues that artificial intelligence (AI) now presents an …
Generalist physicians and AI are a comparative advantage
An excerpt from Medicine at the Crossroads: Commentaries from a Profession Caught Between Patients, Politics, Technology, and Trust.
An emergency medicine physician writing in the New York Times recently described an interaction she had with an AI chatbot that might be a teaching lesson for our profession. After receiving her own lab results, she tried to discuss them with her physician. She was told a phone call would require …
Patients are turning to AI because doctors lack time
There is a number most physicians carry quietly, and a second number almost none of them are told.
The first: If you practice medicine in the United States, the odds that you will be named in a malpractice claim at some point in your career are high, and in some specialties close to certain. The American Medical Association’s most recent analysis of its Physician Practice Benchmark data puts the share of …
Why a malpractice lawsuit follows you after you win
American health care faces many challenges: rising costs, workforce shortages, an aging population, increasing chronic disease burden, and growing administrative complexity. Yet one of the most important health care crises receives far less attention than it deserves: the declining physical and emotional well-being of the health care workforce itself.
Physicians, nurses, respiratory therapists, pharmacists, physical therapists, and countless other health care professionals devote their careers to caring for others. Yet many …
The health care workforce crisis we keep ignoring
Shortly after midnight on April 16, 2026, a terrified teenage boy placed a 911 call from inside his family’s residence in Annandale, Virginia. Moments later, police officers arrived to encounter a scene of unspeakable devastation. Cerina Fairfax lay dead from multiple gunshot wounds, while the body of her estranged husband, former Virginia lieutenant governor Justin Fairfax, was later discovered upstairs in what authorities described as an apparent murder-suicide following an …
When men falling behind unravels families and futures
When an independent practice evaluates a billing company, the diligence usually concentrates on three questions: what it costs, how clean the claims are, and how fast someone answers the phone. Those are the right questions for choosing between vendors that exist. They say nothing about the scenario practices plan for least and recover from worst: The vendor stops existing. That scenario sounds like an edge case. The data says it …
1 in 12 medical billing companies just vanished
The following piece is an AI-generated character study based on the author’s own self-reflection.
He is the kind of person who learned early that being noticed was a form of safety. Not necessarily through anything dramatic, just enough comparison, enough hierarchy, enough subtle reinforcement that visibility became tied to worth. Somewhere along the way, he internalized a quiet equation: If I am seen, I matter; if I am not, I disappear.
What …
Needing external validation is a strategy that fails
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Your ER doctor has about 25 minutes to figure out your medical history and decide what to do next. Hamad Husainy, an emergency physician and physician executive, explains why so much of that …
Why your ER doctor doesn’t know your medical history [PODCAST]
During my pediatrics rotation, I met a 13-year-old girl with obesity. She was trying to follow her doctor’s advice to eat healthier and exercise more, but it was tough: She lacked access to a gym, her neighborhood lacked sidewalks, and local traffic was fast and busy. It was not safe for her to walk or rollerblade alone, despite her motivation to be more active.
Her problem is a common one in …
The built environment is shaping our patients’ health
I am a proud Pakistani Hoosier.
My father immigrated from Pakistan in 1992 in search of a better life than what was possible back home. After moving around for work in those early years, my parents settled outside Indianapolis when I was four years old, and Indiana has been home ever since. As I now pursue my medical education, I find myself thinking often about the two places that shaped me …
From Pakistan to Indiana: climate change and patient health
From 1992 to 1995 I was a GI fellow. Nothing on the market made clinical sense for endoscopy reporting. The tools available were designed by people who had apparently never performed a procedure or written a note for one. I met a colleague in Australia, and together we built one of the first Windows-based endoscopy reporting systems in the country.
Microsoft Access. It worked.
It worked well until the United States moved …
The case for an AI-native health care platform
We all saw the report on early clinical departure. Women are leaving medicine at age 45.8. A senator immediately replied that we needed to be more selective and implied that medical school applicants should accept 30 plus years in a career that is crumbling under our feet.
We know the data. Women physicians have higher burnout than male physicians, and we also know that women physicians have double the suicide …
10 ways to keep women physicians from leaving
Health care leaders often believe organizational struggles are driven by resistance to change. When initiatives fail, engagement declines, or operational performance weakens, the explanation frequently centers on physician pushback, burnout, staffing shortages, or financial pressure. But after years working in complex health care environments, I’ve come to believe many execution failures begin somewhere less visible and far more dangerous: the breakdown of trust between physicians and leadership.
In health care, trust …
Physician trust in leadership drives health care execution
Recent discussions about the employment prospects of PhD graduates in India prompted me to reflect on a broader question that I have considered for many years. India has expanded higher education dramatically over the past several decades, including medical education, doctoral training, and other professional programs. Yet expansion alone does not automatically translate into educational quality, research capacity, clinical excellence, or meaningful career pathways for highly trained graduates. The question …
Has higher education in India kept its promise?
Two people sit in an exam room. One has an illness that will end their life. The other knows. Neither wants to say it out loud, so neither does. The conversation drifts toward next steps (another scan, another line of therapy, another visit on the calendar), and both leave the room feeling that it went well.
This is not a thought experiment. In 2012, the New England Journal of Medicine published …
The collusion in discussing prognosis with cancer patients
We all know the feeling of being in a stressful situation when the body’s fight-or-flight response kicks in. Your palms begin to sweat, your heart pounds, and your blood pressure rises as your brain signals that something may not be safe.
This response can be incredibly helpful when you need to respond to a real threat. However, when the body remains in this heightened state for too long, it can make …
5 ways to calm fight or flight insomnia at bedtime
One of America’s largest and most influential doctor groups earlier this year advised their members to stop conducting surgical interventions on minors who experience gender dysphoria.
In a new position statement, the American Society of Plastic Surgeons noted that “there is insufficient evidence demonstrating a favorable risk-benefit ratio” for those interventions. This announcement represents a watershed moment for the American medical establishment, one that could help spare thousands of vulnerable children …
Pediatric gender transition needs evidence, not ideology
For thirty-five years, I was a practicing vascular surgeon in a four-person private vascular surgery group. For thirteen years, I also served as chairman of surgery for a large health network.
I sat in morbidity and mortality conferences and watched experienced surgeons present cases that quietly revealed patterns. I looked at internal scorecards and noticed which names appeared on the better side of the outcomes curve and which on the worse …
Surgeon outcomes data is no longer ours alone
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