Oh, how I remember this well: The wicked snowstorm that paralyzed many cities, year after year. I was driving my van to work as it slid on black ice and directed me down a hill towards a large church. I had no control and could only pray that I didn’t hit that large telephone pole. When my van finally came to a stop, I realized I had missed the telephone …
Essential personnel safety: the hypocrisy of hospital snow policies
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Physician and health care consultant Harvey Castro discusses his article “ChatGPT Health in hospitals: 5 essential safety protocols.” Harvey outlines the immense potential of large language models to reduce administrative burdens while …
Hospitals must establish safety guardrails before deploying AI [PODCAST]
There is a kind of discipline that develops quietly over time, shaped not by certainty, but by persistence. I often think of it as the Mamba Mentality: a commitment to steady improvement, resilience, and focus on the process rather than the outcome.
For many immigrants, this mindset is not aspirational. It is necessary.
My own journey reflects this reality.
Before coming to the United States in 2007, I spent one year in the …
The Mamba Mentality of an immigrant physician’s journey
Over the past two decades, hospital systems have increasingly acquired physician practices, arguing that integration improves care coordination, lowers costs, and stabilizes struggling practices. In reality, this consolidation has often produced the opposite effect: higher costs, reduced physician autonomy, diminished innovation, and care that is less responsive to patients’ needs. While hospitals and physicians must collaborate closely, ownership is not collaboration, and hospital systems should not be in the business …
Why hospitals shouldn’t own physician practices: 6 key reasons
I’d rather be a sex worker than practice medicine in this broken system (and I’m 53, menopausal, and retired from my hot years).
Let me be clear: This is not a whimsical “maybe I will pivot into OnlyFans” moment. I am 53 years old. I am menopausal. My libido is in witness protection. The bloom is not just off the rose, the whole damn bush was yanked out and replaced with …
Why does sex work seem like a more viable path than medicine in 2026?
The world has slipped out of rhythm,
like a clock knocked from the wall
that still insists on ticking,
though the hours no longer agree.
Nothing aligns with the way it lived
in my body a year ago.
Then, there was a sense of ballast.
Morning came without dread
clinging to its edges.
I could rise,
place my feet on the floor,
and believe, perhaps naively,
that the ground would hold.
I believed the voices we chose would,
at minimum, remember us.
That disagreement was …
Finding balance in political turmoil: a poem on resilience
I cannot recall the first time my name was mispronounced; that is the point. It happened so often that no single moment stands out. The sounds were altered to make them easier. In first grade, a boy loudly said my name sounded like “cereal.” I disliked it but did not tell a teacher. Early on, I learned how others would value attributes like skin color, regardless of my permission.
When adults …
Names as social texts: Navigating cultural identity in medicine
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Psychiatrist, internist, and addiction medicine specialist Muhamad Aly Rifai discusses his article “Unregulated botanical products: the hidden risks of convenience store supplements.” Muhamad explores the dangerous misconception that “natural” equals safe, revealing …
Unregulated botanical products pose hidden risks in convenience stores [PODCAST]
My eyes opened with the familiar heaviness of a Monday morning, and as I began to pull myself out of bed, I felt a shooting pain in my neck. I was alarmed, but not wanting to be too dramatic, I repositioned on my side, pushed off and got to my feet, struggled to put a dress on without moving my neck, and headed to class. Finding that the painless range …
What neck pain taught a medical student about patient trust
For half a century, the “gold standard” of labor safety has been a single, flickering line on a screen. But as recent reporting confirms, that line is often a lie. Our obsession with isolated fetal heart rate patterns has created a surgical “false positive pipeline,” driving C-section rates to historic highs without actually reducing the incidence of cerebral palsy.
The myth of the “failed” test
The skepticism surrounding EFM often stems from …
Artificial intelligence and the future of fetal heart rate monitoring
“Mom says she talks to me every day now.”
The son told me this during a clinic visit. His 82-year-old mother, once painfully lonely, now smiled again. She told everyone she spoke with her son every morning. He asked about her day. He reminded her to take her medication. He listened to her stories.
There was only one problem.
She was not talking to her son. She was talking to an AI voice …
The hidden dangers of AI voice assistants in elder care
Even with all the incredible advances in medicine over the past 70 years, there remain severe deficits in the care of many serious deadly diseases. Pancreatic cancer, multiple sclerosis, glioblastoma, Alzheimer’s, ALS, and ovarian cancer easily come to mind in that desperate category.
However, let’s get a perspective of what it was really like to practice medicine a hundred years ago. What kind of doctors were there? What did they do? …
Medicine in 1926: What being a doctor was really like
An excerpt from In Search of Dignity: A Lifetime of Reflections.
Several years before her death at the age of 55 years due to complications of cerebral palsy, my sister Ellen was again in hospital, this time in intensive care and on the brink of respiratory collapse. To say cerebral palsy had shaped her life is an understatement, in that it molded nearly every facet of her being, from the …
The Platinum Rule in health care: Moving beyond the Golden Rule
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Internal medicine physician Shiv K. Goel discusses his article “Claude for Healthcare vs. administrative burden: a physician’s review.” Shiv contrasts the two hours he spent fighting a prior authorization with the promise …
AI could end the administrative nightmare for doctors [PODCAST]
Most people expect a heart attack to announce itself with unmistakable force, crushing pain, shortness of breath, a dramatic collapse. Mine arrived quietly, unnoticed, and remained hidden for years. What I discovered in 2026 forced me to revisit events from 2018 and 2019 and confront how easily critical medical information can slip through the cracks when communication fails.
A routine appointment reveals a hidden past
On Jan. 8, 2026, during a routine …
Silent heart attack symptoms: my missed diagnosis story
I cannot claim to have been the one who nurtured our garden. That credit belongs to my wife. She is the one who waters the plants faithfully and notices when something needs care. I am more often the admirer, the one who pauses to appreciate a flower that seems almost too beautiful to belong in an ordinary backyard.
Among the plants that brought me the greatest joy was a passion vine. …
The passion vine: a lesson on restraint in medicine and life
Predicting shifts in the health care environment has always been difficult, but this year, the pace of change, driven by regulatory complexity, mounting financial pressures, and artificial intelligence (AI), makes long-term forecasts increasingly uncertain. Each year, TDC Group has predicted emerging health care trends over the next decade, focusing on the challenges, risks, and opportunities that shape the industry. …
The future of U.S. medicine: 10 health care trends in 2026
I read with interest HHS’s request for public input on how regulation, reimbursement, and research and development can accelerate the adoption of artificial intelligence in clinical care. As someone who began his career as a software engineer, then became a practicing physician, and later founded a clinical AI company, I welcome this moment. It is overdue, and it is also fragile.
The promise of efficiency over autonomous medicine
AI’s greatest opportunity …
Artificial intelligence in clinical care: Shaping the HHS policy landscape
The way hospitals traditionally staff is burning out nurses and killing patients.
A single call-in or unanticipated census spike creates heavier patient loads for front-line nurses. Research published in the Journal of the American Medical Association found that surgical patients have a 31 percent increased likelihood of death within 30 days in hospitals with 8:1 nurse-to-patient ratios, compared to those with the optimal 4:1 ratio.
Further, when nurses were asked why …
Predictive staffing in health care: Solving the nurse burnout crisis
An excerpt from Narrative Medicine in the Age of Uncertainty: When Systems Strain and Stories Steady.
When a nonprofit hospital system posts a $201 million operating loss, lays off roughly 650 workers, and then buys naming rights to an NFL practice facility, it does not just create bad optics. It teaches a lesson.
Not to the marketing department. To the workforce.
In Philadelphia, Jefferson Health reported a $201 million …
Why your nonprofit hospital system is spending millions on marketing
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