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Physician and tax specialist Logan Foltz discusses the article “Physician tax strategies: Why your tax bill is so high and how to fix it.” Logan explains why the Internal Revenue Code patterns …
Why physicians pay more in taxes and how to reclaim your income [PODCAST]
The treatment of cardiovascular diseases has advanced at an extraordinary pace over the past half-century resulting in an age-adjusted 60 percent reduction in heart disease death rates. This dramatic decline is directly attributable to primary and secondary preventive therapies such as statins and small interfering messenger RNAs along with disruptive technologic advances in procedural techniques. New pharmacologic options for thromboprophylaxis and novel therapies for heart failure …
Why cardiovascular medicine should focus on patients, not environmental advocacy
One prominent characteristic of medicine is its ability to repeatedly remind you to be humble. There is always something new to learn about it, and in real life patients rarely present exactly as they do in the textbook. On top of that, health care workers commonly feel pressure to be perfect due to the potentially serious consequences of many medical mistakes. Of course, since we are human, we are bound …
Medical mistakes happen and you are still enough
Every week in the pediatric emergency department, I see the consequences of adolescent substance use that started too early and went unaddressed for too long. A teenager in crisis. A family blindsided. A window of prevention that closed long before anyone realized it was open.
We keep asking the same question: How do we reach kids before it gets to this point?
The answer, it turns out, might already be sitting in …
Peer-led storytelling in adolescent substance use prevention
“Pathology confirms invasive ductal carcinoma.”
I had said those words to patients many times before. This time, they were said to me. For years, I had been the voice on the other end of that call, gently guiding patients through one of the hardest moments of their lives. I knew how to say the words. I knew how to explain the diagnosis. I knew how to help women process what came …
Navigating dense breast tissue and breast cancer screening guidelines
It was a typical weekday morning. I woke up at 5:20, started a load of laundry, showered, dressed, unloaded the dishwasher, got the kids breakfast and lunch together, fed the pets, etc. After sending my husband off to work, I got the kids up and ready for the day. Things were going smoothly. I got my kids to school on time, and got into work early enough to go through …
Balancing part-time clinical work and motherhood
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Physician coach Apurv Gupta discusses the article “What is a loving organization?” Apurv describes his model of a loving organization as a system that designs the clinical environment to make safety and …
Why loving organizations are the secret to ending burnout in medicine [PODCAST]
15642, five numbers that have shaped my life. We all have a zip code that we call home, yet some of us can face detrimental health outcomes based on where we live. Dementia does not discriminate by zip code, but the comprehensiveness of care and patient outcomes often do. Rural families face greater barriers to accessing dementia care resources, which deepens inequities between urban and rural health care. Barriers include …
Bridging the gap in rural dementia care with technology
The modern acquired immunodeficiency syndrome (AIDS) epidemic was first recognized in the United States in early June 1981, when clusters of rare opportunistic infections were reported in young gay men in Los Angeles and other cities. Before the cause was understood, it was commonly called “GRID” (gay-related immune deficiency). In popular and some medical discussions, it was also referred to as the “gay plague,” “gay cancer,” and similar gay-specific labels. …
The hidden realities of the HIV/AIDS epidemic and U.S. health care policy
Patient engagement platforms are software systems that deliver clinical information to patients and manage patient questions and concerns outside of scheduled visits, including patient portals, mobile apps, and messaging systems. After nearly a decade of watching (and studying) the evolution of patient engagement platforms, I have come to see them as two distinct generations. I will refer to them as Generation 1 and Generation 2. Not because this distinction exists …
Understanding Generation 2 patient engagement platforms
I review your peer-to-peer calls. Here is why you keep losing.
I sit on the other side of your peer-to-peer call.
I am a physician medical director in utilization management. When you call to overturn a denial, I am the one listening. I have taken thousands of these calls over the past decade. I can tell within the first 30 seconds whether you are going to win.
Most of you lose. Not because …
How to win peer-to-peer calls: a medical director’s guide
We have been calling it burnout. The word took decades to arrive, and then it was everywhere. It appears in journal editorials, hospital wellness initiatives, and continuing medical education (CME) modules on resilience. It has validated scales. It is now the official language of physician distress. It is not wrong. But it is incomplete. It describes something real: exhaustion, detachment, the slow erosion of meaning. But burnout describes how the …
Beyond physician burnout and understanding structural immiseration
Requests for prayer at the bedside are more common than many clinicians admit. Yet these moments often unfold quietly, undocumented, unexamined, and rarely addressed in training. Whether a clinician identifies as religious, spiritual, secular, or uncertain, such requests can stir discomfort. Still, patients continue to ask.
Sometimes it is direct: “Doctor, will you pray with me before surgery?”
Other times it is woven into hope: “I am praying God gives your steady …
When patients ask to pray: Navigating spirituality in medicine
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Obesity medicine physician Jessica Duncan discusses the article “GLP-1 weight regain: Why stopping medication leads to weight return.” Jessica explains that expecting to maintain weight loss after abruptly stopping GLP-1 therapy is …
Why weight regain is a predictable biological response after stopping GLP-1s [PODCAST]
On October 20, 2015, I did something unremarkable: I turned on the GPS app on my Android phone before driving to work. I had no idea that routine act would one day save my career and expose a pattern of institutional behavior that every academic physician needs to understand.
I was an assistant professor of oral and maxillofacial surgery at a major academic medical center. Two days after a high-risk patient …
Physician legal protection: Surviving academic medical center blame
What happens when the doctor becomes the patient? Is there anything learned or reinforced? For me, it was a life-changing experience both personally and professionally when I became the patient.
My story began on New Year’s Eve. I had been feeling dizzy associated with some chest pain and was scheduled to have a stress echo at my local hospital to make sure all was OK (of course it would be OK, …
Surviving ventricular tachycardia: What I learned as a patient
Imagine a healthy eight-year-old boy going under general anesthesia for a routine procedure. His preanesthetic workup is unremarkable. His family history raises no flags. He receives sevoflurane, the most commonly used inhaled anesthetic in pediatric practice worldwide, and he does not wake up the same.
This is not a theoretical scenario. It has happened to families of Venezuelan ancestry on multiple continents, across multiple decades, and no one connected the dots. …
How a hidden genetic mutation creates a severe pediatric anesthesia risk
They tell us doctors
to practice self-care,
as if grief were a muscle
that loosens with stretching.
But no one teaches
how to set down
a conversation about dying
and pick up
the rhythm of living.
At the end of the work day,
the questions still echo,
How much time do I have?
What would you do, doc?
The charts are closed,
but the questions remain open.
Burnout does not arrive
as flames.
It seeps,
through the small cracks
between hope and reality,
between doing everything possible
and knowing we have …
A physician’s poem on burnout and end-of-life care
A publication in Nature in April 2026 reports that N-desethyl-fluornitrazene (DFNZ), a modified nitazene and µ-opioid receptor (MOR) superagonist, produced potent analgesia in rodents with less respiratory depression, weaker dopamine-linked reward signaling, lower withdrawal burden, and no clear tolerance or MOR downregulation. The study challenges the usual assumption that very high MOR efficacy must inevitably produce the full adverse-effect profile seen with conventional opioids. Opioid pharmacology has long been …
How the opioid superagonist DFNZ challenges pain medicine
In the operating room, precision has never been greater. Modern surgery now relies on navigation systems, artificial intelligence, robotic assistance, digital planning platforms, and predictive analytics capable of modeling outcomes before the first incision is made. For the first time in medical history, technology allows surgeons to simulate procedures, optimize implant positioning, and reduce technical variability to levels once unimaginable.
Yet many surgeons recognize an uncomfortable paradox emerging beneath this progress: …
Artificial intelligence in surgery: Balancing precision with clinical wisdom
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