I love comedy clubs. Always have. My wife calls them my happy place and she’s not wrong. Although I haven’t had the opportunity to attend one recently, I often find myself immersed in stand-up clips from the likes of Dave Chappelle, Chris Rock, Kevin Hart, and a constellation of other comedic virtuosos. Back in the pressure-cooker days of my residency training in New York City, those clubs were my sanctuary. …
A man sat in my waiting room, heart racing—not from chest pain, but from panic. He’d been Googling his symptoms all night. Not afraid of what is—terrified of what might be. This is the anticipatory anxiety of modern medicine—a silent epidemic that strikes before any diagnosis ever does.
Patients no longer arrive with just symptoms. They bring stories already constructed. Hours of scrolling. Threads of worst-case scenarios. Algorithms feeding fear. By …
There was a time — not too long ago — when I dreaded the start of each workweek.
I had spent years studying, training, and sacrificing sleep, time with family, and even my health to become a physician. I believed in the value of primary care and the importance of relationships with my patients. But somewhere along the way, the dream started slipping through my fingers. I wasn’t unhappy because of …
“When doctors strike, patients die.” That phrase—flattened into certainty—gets tossed around like a moral verdict. It shows up in op-eds, comment threads, morning rounds. As if to say: there’s no argument. The matter’s settled. You swore an oath.
But what oath, exactly?
Most physicians are taught to revere the Hippocratic Oath, but few have read the original versions. It wasn’t universal. It wasn’t sacred scripture. It forbade surgery. It invoked Apollo and …
Well before I was a physician, I was an art history major at Bowdoin College. Beneath towering pine trees, I spent much of my time in dim lecture rooms off the quad and in the quiet galleries of Maine’s art museums, studying paintings, sculptures, and photographs to understand not just what was being portrayed, but also what they revealed about the people, places, ideas, and defining events of their time. …
Clinical trials are the cornerstone of progress in cancer treatment. Yet, paradoxically, the very patients these trials are designed to help often face the greatest obstacles to participation. While the concept of “patient-centered” clinical trials has been around for years, more than 20 percent of U.S. clinical trials fail to accrue a sufficient number of participants, forcing them to fold.
Why aren’t patients enrolling in clinical trials?
While there have …
In medicine, one surprisingly heated debate doesn’t get much airtime: Should patients call their doctors by their first name?
It pops up often on medical forums. I’ve seen long threads dissect whether it’s disrespectful, whether it undermines authority, or whether it reflects a cultural shift in how we view physicians. Some doctors insist on “Doctor” as a matter of principle—status, respect, professionalism. Me? I appreciate being called Dr. Nadelson. It reflects the …
The transformation of care delivery is driven by value-based health care (VBHC). In addition to its cost-effectiveness and clinical efficiency, the success of VBHC depends upon its ability to exemplify empathy and equity. Usually disregarded in pursuing metrics, data, and integrated payments, these two pillars are indispensable for implementing a system that provides dignity and equity to all patients. Embedding empathy and equity into health care delivery is no longer …
This past St. Patrick’s Day my daughter and I were listening to John Lennon’s Luck of the Irish. She wondered aloud whether people realized the phrase was meant to be ironic. Lennon certainly did, singing, “If you had the luck of the Irish, you’d be sorry and wish you were dead …” With Irish-born grandparents and Liverpool’s deep Irish roots, he understood the weight of the phrase, eight hundred years …
As yet another tragic chapter unfolded in the intractable and ever-escalating Iran-Israel conflict, I found myself in the midst of conversations, intense, impassioned, and sometimes uncomfortably raw. The participants weren’t diplomats or scholars. They were ordinary people, men and women, brown and white, Jews and Arabs, Muslims and Christians, all fiercely devoted to their own perspectives, each convinced they were defending not merely an opinion but the truth.
One particularly striking …
In the once-venerable corridors of our state’s flagship academic hospital, a slow-motion disaster is unfolding. White patients — yes, white patients, because that’s who’s leaving — are abandoning ship, hightailing it to the quieter, politer hospitals in “white” suburbs. Why? Because the “uniformly Mexican” staff — medical assistants, front desk drones, and nursing staff — treat customer service like it’s a foreign concept. And frankly, it is. Mexico isn’t exactly …
I’ve taken some amazing vacations. Seriously—scenic, memorable, cool stuff. Travel has always been a top financial priority for me. It felt like one of the few things in life that reliably gave me joy and perspective.
And in many ways, I still believe in the value of taking time away. But over the past year, my perspective on why I take vacations—and what I’m actually hoping to gain—has changed in some …
What’s a dyad and how do I fit into it?
What do I do? These are the questions every new health care leader asks themselves, as I did, when they first join a dyad partnership. Although there has been much academic writing regarding leadership dyads in health care, with a macro focus on structure and accountability and implementation, there is a paucity of material on the practical aspects of a dyad …
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She works for a not-for-profit health system, but nothing about what she described to me felt charitable. A young physician, just a few years into her career, she’s already facing a choice that no doctor should ever have to make: protect her patients or protect the metrics that determine her employer’s paycheck.
The heart of the problem
This physician works under a value-based payment model. On paper, it sounds great: Pay doctors …
As physicians, we are trained to care—for patients, colleagues, and our communities.
When it comes to caring for our own aging parents and ill family members, most of us find ourselves overwhelmed, overfunctioning, under-resourced, depleted, and isolated. More often than not, we find ourselves assigned the caregiving role—explicitly or implicitly—because we’re “the doctor in the family.”
We think our medical training should make caregiving easier. But the opposite is true. We know …
We often hear the phrase “practice what you preach.” As both a physician and a patient, I’ve learned that nowhere is this more important than in how we navigate health care.
Over the years, I’ve written about the importance of collaboration between physicians and patients. But as I’ve grown older and more frequently interact with the health care system, I’ve come to believe that good care rests on four essential elements:
WeightWatchers (WW) recently completed a broader financial reorganization, realigning leadership with a sharper focus on clinical innovation and women’s health, including menopause support. The reorganization includes appointing a chief medical officer to lead a more integrated, medically informed approach.
WW’s reorganization bankruptcy was driven by mounting debt and pressure from newer weight-loss therapy products, namely GLP-1 drugs like Ozempic and Wegovy. It was also impacted by a shifting landscape where traditional …
An excerpt from Pandemics, Poverty, and Politics: Decoding the Social and Political Drivers of Pandemics from Plague to COVID-19.
Many transgender (TG) people live with the constant threat of violence. International research documented a total of over 2,000 murders of TG humans between January 2008 and April 2016.43 (These findings are likely greatly underreported.) Even more widespread is nonlethal violence against TG communities. A national U.S. study indicated that 35 …
Are you serious? It’s 2 a.m., and you take a patient to the OR for what you believe is a bowel obstruction or appendicitis — only to find metastatic cancer, necrotic bowel, or something equally catastrophic. The patient is unstable, anesthesia is struggling to maintain blood pressure, and you can’t simply apply a wound vac and leave the patient in the ICU. This is when your training must take over.
Since …
One of the most important—and least discussed—truths in medicine is this:
Feeling inadequate in medicine isn’t rare. It’s everywhere—quiet, lingering, relentless.
I remember starting my outpatient practice right out of residency. I had joined a large multispecialty group filled with physicians trained at top-tier institutions. Many had been practicing for decades. They were confident. Efficient. Experienced. I was still waiting on my board scores—unsure if I was even certified yet. And yet—there …
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