Arthur Lazarus, MD, MBA

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia. He is the author of several books on narrative medicine and the fictional series Real Medicine, Unreal Stories. His latest book, a novel, is JAILBREAK: When Artificial Intelligence Breaks Medicine.

Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

Conditions

February 15, 2026

As reported in the Philadelphia Inquirer, Louis-Hunter Kean was 34 years old when he died in November 2023 at the Hospital of the University of Pennsylvania (HUP). For more than a year, he endured cyclical fevers as high as 104.5 F, drenching night sweats, profound fatigue, hepatosplenomegaly, cytopenias, and escalating inflammation. Over six months in 2023, he was hospitalized five times. His electronic medical record ballooned to …

2026 Winter Olympics rumors: the truth about ski jumpers and hyaluronic acid

Arthur Lazarus, MD, MBA

Physician

February 13, 2026

An excerpt from Still Life with Stethoscope and Typewriter: Essays and Echoes of Narrative Medicine.

Every Olympic Games eventually produces its own mythology. Not the noble kind, ancient Greeks crowned in olive leaves, but the modern variety, where rumor, technology, desperation, and money form a cocktail best consumed at a safe distance.

The 2026 Winter Olympics in Milan have already delivered one such legend: the claim that elite ski jumpers were …

AI in medicine vs. aviation: Why the autopilot metaphor fails

Arthur Lazarus, MD, MBA

Physician

January 24, 2026

The pilot of a commercial aircraft, descending into near-zero visibility, hands control to an automated system designed for precisely that moment. The landing is flawless. The passengers are safe. The pilot announces it proudly. Technology functions exactly as promised.

A doctor on board writes, “It made me think about the health care journey I am on with AI. The safety and well-being of 140 people wasn’t left to human intervention; the …

FDA loosens AI oversight: What clinicians need to know about the 2026 guidance

Arthur Lazarus, MD, MBA

Policy

January 18, 2026

On January 6, 2026, the FDA announced revised guidance that loosens oversight for certain AI-enabled digital health products, most notably clinical decision support (CDS) software. The goal was to cut unnecessary regulation and promote innovation, accelerating time-to-market for tools positioned as clinical assistants rather than autonomous decision-makers.

At first glance, the change looks pragmatic, even overdue. For years, developers and clinicians alike have complained that prior FDA interpretations forced artificial …

The moral injury of “not medically necessary” denials

Arthur Lazarus, MD, MBA

Physician

January 16, 2026

The first denial arrived not with cruelty or malice, but with a phrase so familiar it barely registers as language anymore: “not medically necessary.” The cancer drug, recommended by oncologists and supported by evidence and standard of care, was rejected. No phone call. No physician-to-physician conversation. Just an automated letter and a bureaucratic pause inserted into a life that no longer had room for delay.

The family appealed. They fought. They …

WISeR Medicare pilot: the new “AI death panel”?

Arthur Lazarus, MD, MBA

Physician

January 11, 2026

There are many ways to say “no” in medicine.
“No, this antibiotic won’t help a viral infection.”
“No, this test won’t change our management.”
“No, that surgery carries more risk than benefit.”

And then there is the newest way:
“No, the algorithm doesn’t prioritize your health.”

Welcome to WISeR, short for “Wasteful and Inappropriate Service Reduction,” a Medicare pilot program that promises to usher artificial intelligence into health care decision-making with all the subtlety of …

Psychedelic retreat safety: What the latest science says

Arthur Lazarus, MD, MBA

Physician

January 9, 2026

“Turn on, tune in, drop out” was a rallying cry for liberation. “What a long, strange trip it’s been” is how we nostalgically narrate the aftermath. Psychedelic-assisted therapy now sits somewhere between those two cultural bookends: a rapidly professionalizing clinical enterprise and a booming, loosely regulated marketplace of “retreats” selling healing, insight, and transcendence.

The science behind psychedelics is more real than ever. So are the risks. The problem is …

Geography as destiny: the truth about U.S. life expectancy disparities

Arthur Lazarus, MD, MBA

Policy

January 5, 2026

Every New Year arrives with its familiar rituals. We raise a glass, make a resolution, and offer a toast to things we hope will be different this time around: better habits, better balance, better health. We say “I’ll drink to that” as shorthand for optimism, an easy affirmation that the future is still negotiable and a longer life is possible.

Then along comes a map.

Physician attrition rates rise: the hidden crisis in health care

Arthur Lazarus, MD, MBA

Physician

January 2, 2026

America’s physician shortage is no longer a distant projection. It is happening now, steadily, one resignation, early retirement, and practice closure at a time.

A nationwide, longitudinal analysis published in Annals of Internal Medicine tracked more than 712,000 physicians caring for Medicare patients over a decade and found a troubling trend: Physician attrition from clinical practice rose from 3.5 percent in 2013 to 4.9 percent in 2019, across every specialty, …

“The meds made me do it”: Unpacking the Nick Reiner tragedy

Arthur Lazarus, MD, MBA

Meds

December 25, 2025

“The meds made me do it” has become a familiar refrain whenever psychiatric treatment intersects with tragedy. It is a phrase heavy with implication, suggesting loss of control, a sense of medical betrayal, and a system that failed at its most basic task: keeping people safe. When cases like the Nick Reiner tragedy enter the public consciousness, that phrase resurfaces almost reflexively, offering a deceptively simple explanation for something incredibly …

Direct primary care vs psychotherapy models: Why they aren’t interchangeable

Arthur Lazarus, MD, MBA

Physician

December 23, 2025

I read Zoe Crawford’s thoughtful KevinMD essay on the limitations of direct primary care (DPC) with great interest. Her frustration as a medically complex patient navigating a fragmented health care system will resonate with anyone who has struggled to obtain timely imaging, referrals, or specialty care. As a clinician who has spent a career thinking and writing about how health systems fail both patients and physicians, I agree with …

The political selectivity of medical freedom: a double standard

Arthur Lazarus, MD, MBA

Policy

December 22, 2025

I’ve been thinking about “choice” a lot lately, not the rich, ethically grounded version we teach in medical school, rooted in autonomy, informed consent, and shared decision-making, but a thinner, more selective version now circulating in political and legal discourse. The kind that sounds principled until you read the fine print.

The message goes like this: You may choose, just make sure you choose correctly.

It’s the literary equivalent of Animal Farm: …

Finding meaning in medicine through the lens of Scarlet Begonias

Arthur Lazarus, MD, MBA

Physician

December 18, 2025

“Once in a while you get shown the light
In the strangest of places if you look at it right.”

That line from Scarlet Begonias (lyrics by Robert Hunter, melody by Jerry Garcia) has followed generations like a benediction disguised as a song lyric. Released in 1974 on the Grateful Dead album From the Mars Hotel, it has become something more than poetry. It is a philosophy of attention, a reminder that …

Does medical training change your personality?

Arthur Lazarus, MD, MBA

Physician

December 12, 2025

Something very distinctive happens once students complete medical school and residency: some of them start acting like excrement. Not all, but enough that most of us have witnessed the transformation. Maybe you’ve noticed it in your mentees, or in the children of friends and colleagues who went into medicine. Maybe, uncomfortably, you’ve wondered if it happened to your own children. And, if you’re like me, reflecting at the tail end …

Modern eugenics: the quiet return of a dangerous ideology

Arthur Lazarus, MD, MBA

Physician

December 8, 2025

I’m not paranoid. And I don’t believe in conspiracy theories. But as a physician who has spent decades watching the pendulum of medical ethics swing back and forth, I can’t ignore the pattern emerging across public health and politics today. Some of what I’m seeing looks uncomfortably familiar. It looks like eugenics, not the caricature of white coats and calipers, but the quieter, policy-driven, values-encoded version that shaped America a …

Finding integrity at the end of a career

Arthur Lazarus, MD, MBA

Physician

September 28, 2025

An excerpt from Born to Heal: Medical Narratives Set to the Soundtrack of Classic Rock.

Dr. Raul Morales sat alone in Exam Room 3, now used for storage, staring out at the fading autumn light through a slit in the blinds. The clinic was quiet, eerily so. His last patient had left an hour ago. He was supposed to be packing up his …

Why medicine is like a jazz solo

Arthur Lazarus, MD, MBA

Physician

September 6, 2025

An excerpt from Born to Heal: Medical Narratives Set to the Soundtrack of Classic Rock.

Dr. Evelyn Moore had always believed medicine was more than a profession; it was a calling. Not in the dramatic, messianic sense that some doctors held onto (where they saw themselves as saviors) but in the quiet, steady way a lighthouse stands guard over stormy waters. She was not there to rescue …

Read more…

Why medicine is like a jazz solo

Why real medicine is more than quick labels

Arthur Lazarus, MD, MBA

Physician

August 16, 2025

An excerpt from Real Medicine, Unreal Stories, Volume 3.

The café was quiet, tucked between a shuttered bookstore and a yoga studio that only seemed to open during Mercury retrograde. It was the kind of place that didn’t advertise, which made it perfect for writers, wanderers, and today, two physicians who had long since discovered that stories, not stethoscopes, were the truest diagnostic tools.

Dr. Gary Handler stirred his coffee absentmindedly, …

Forced voicemail and diagnosis codes are endangering patient access to medications

Arthur Lazarus, MD, MBA

Meds

July 8, 2025

I won’t be using CVS pharmacies anymore. Sure, I may still need to send prescriptions their way as a physician—but as a consumer, I’m done.

Why?

CVS has recently implemented a new phone system that forces callers to leave a voicemail instead of waiting on hold. The idea is to streamline operations, letting pharmacy staff return calls when they have time. It’s supposed to manage call volume, reduce wait times, and shield …

International doctors blocked by visa delays as U.S. faces physician shortage

Arthur Lazarus, MD, MBA

Physician

June 28, 2025

This story is fiction but inspired by the real and worsening challenges faced by international medical graduates navigating U.S. immigration policy.

The acceptance letter sat printed on top of Nabeel Khan’s passport, still warm from the old inkjet printer in his family’s living room in Lahore. The words glowed like prophecy: “Congratulations! We are thrilled to welcome you to our Internal Medicine Residency Program at St. Julian’s Hospital, Topeka, Kansas, …

Arthur Lazarus, MD, MBA

Arthur Lazarus, MD, MBA

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