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Integrative pediatrician Mary Wilde discusses the article “The pause medicine never taught us to take.” Mary discusses how medical training conditions clinicians to fear rest and prioritize a treadmill of servitude over …
Why physicians must reclaim their right to pause [PODCAST]
Working the night shift is brutal. Circadian rhythms are disrupted, backup help in true emergencies is limited, and even simple things like labs or imaging can take far longer than they should. But one of the biggest challenges is late-night snacking.
There is something about the combination of darkness, fatigue, and intermittent slow periods that makes it ridiculously easy to inhale a two-pound bag of potato chips without thinking twice. Research …
Night shift weight loss: a practical fasting guide for physicians
The saying, “treat the patient, not the X-ray,” captures a core challenge we face in spine practice: Clinical symptoms and imaging findings often do not align, making it crucial to approach imaging with a structured framework. This lesson was evident when we treated two patients with strikingly different presentations. The first was a 35-year-old woman whose MRI report identified severe scoliosis and spinal stenosis. Yet, she was totally asymptomatic, with …
Why MRI classification systems improve spinal stenosis care
Fifty years ago, being a doctor was like being a cross between a wizard and a rock star. People would whisper in awe when you walked by: “There goes Dr. High-and-Mighty, saving lives and curing everything from a runny nose to a broken heart!” My dad used to tell me stories about how he would get waved past security, cut to the front of lines, score doctor discounts, and park …
The death of medical swagger: How physician status has changed
The terms parkinsonism, Parkinson disorder, and Parkinson syndrome are all synonymous and can be used interchangeably depending on which you prefer. All of these terms refer to the symptoms. To be diagnosed with a Parkinson disorder, you must exhibit two out of three of the following motor symptoms:
This is with or without postural instability, which usually refers …
Atypical Parkinson disorders vs. Parkinson disease: key differences
People often say doctors should perform like flight or rescue teams. The comparison sounds flattering. It is also incomplete. Pilots, ship captains, firefighters, coastguards, and rescue teams all work in high-stakes environments. They train hard. They lead under pressure. They make critical decisions with lives at risk. Medicine shares that gravity. But the real-world challenge of clinical medicine is often more complex, less controlled, and more exposed to uncertainties than …
Why clinical medicine is harder than flying a plane
As a reproductive endocrinologist, I spend a great deal of time trying to answer a deceptively simple question: Why is not this couple getting pregnant? Male factor infertility contributes to at least 40 percent of cases, and most reproductive endocrinologists recognize the importance of evaluating both partners early. In practice, however, the path to that evaluation is not always straightforward. In heterosexual relationships, patients may understandably focus first on the …
What is often overlooked about male factor infertility
Globally, about $1 trillion has been spent on diabetes-related treatment, a 338 percent increase over the last 17 years, according to the International Diabetes Federation. And yet, 3.4 million deaths were related to diabetes in 2024. This shows the massive strain diabetes has placed on health systems worldwide. One of the most common and debilitating complications of diabetes is non-traumatic lower limb amputation. Diabetes …
Preventing diabetic lower limb amputation with AI and offloading
As a physician who treats people with chronic pain, stress-related illnesses, and the lasting physical effects of emotional trauma, I have begun seeing a deeply troubling pattern in my exam room. Parents arrive exhausted, anxious, and physically unwell. Their symptoms rarely come from one obvious injury or disease. Instead, they stem from an ongoing emotional battle taking place right inside their own homes: their teenager’s struggle with online gambling addiction. …
The hidden health crisis of teenage online gambling
Every physician recognizes the serpent and the staff. It appears on hospital logos, medical schools, and ambulance doors, so familiar that few of us stop to ask what it actually means.
Many assume the symbol of medicine is the caduceus: two snakes, wings, and a staff. It is not. That emblem belonged to Hermes, the Greek god of commerce, negotiation, and speed. Its twin serpents represent exchange and trade, apt for …
The serpent and the staff: the ancient origins of the medical symbol
Advance directives pale in comparison to the real-time medical decisions caregivers make every day, whether to encourage medication, contact a specialist, call 911, or continue treatment for a loved one. National Healthcare Decisions Day (NHDD), observed each year on April 16, encourages individuals to complete an advance directive. But when the true day of reckoning arrives, when death seems imminent, disfigurement is likely, or mental capacity is lost, this document …
Caregiver end-of-life decisions: Moving beyond advance directives
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Metabolic health educator Marsha Shepherd Whitt discusses the article “Why ‘eat less, move more’ fails for midlife weight loss.” Marsha explains that weight loss struggles in midlife are often driven by physiology …
Why hormonal shifts make traditional dieting ineffective for midlife women [PODCAST]
You took an oath not to be a machine,
not to be a ledger of codes and signatures,
not to be a pair of hands
moving briskly from room to room
as if compassion could be measured in 15-minute increments.
You took an oath to listen for the tremor beneath a voice,
to feel for the pulse that falters under your fingertips,
to stand between suffering hope and say,
“I will try.”
But somewhere between the stethoscope and the …
Physician burnout: a poem on the unseen weight of medicine
Most skilled nursing facility leaders understand the quality measures that affect their operations. They live with Star ratings and Quality Reporting Program requirements every day. What is less visible is how the clinicians caring for those same residents are evaluated under Medicare’s Merit-based Incentive Payment System (MIPS).
When facilities and clinicians are accountable for the same resident outcomes through different quality programs but lack shared visibility into how those programs are …
How Medicare’s MIPS impacts skilled nursing facilities and clinicians
The rise of artificial intelligence-generated profiles means that by 2028, globally, one in four job candidates will be fake, according to research and advisory firm Gartner. Once hired, an impostor can install malware to demand a ransom from a company, steal its customer data, trade secrets, or funds. That is one side of the coin. Here is the other: the fake recruiter. I have been receiving emails from recruiters …
How to spot artificial intelligence recruiters who target candidates from LinkedIn
For more than two decades, I have worked in health insurance, first at insurers and more recently as a consultant on Medicare policy. I have led large Medicare Advantage analytics and actuarial organizations comprising actuaries and data scientists working to improve care delivery, manage costs, and optimize revenue. Having seen firsthand the sophistication insurers bring both to improving care and to maximizing revenue within the rules, I find today’s MA …
The truth about Medicare Advantage funding and costs
Every clinician has encountered this moment. A patient leans forward and says, “But doctor, I was fine yesterday.” The statement carries confusion, frustration, and sometimes quiet alarm. It also reveals an assumption deeply embedded in both medical culture and human cognition, that stability should look like consistency.
In clinical medicine, predictability is often mistaken for stability. We feel reassured when symptoms follow familiar patterns. Patients feel encouraged when treatments produce repeatable …
Why symptom variability in chronic illness is not failure
Sooner or later, most physicians encounter this moment. A patient arrives at an appointment carrying a thick envelope of disability insurance forms. They look uncomfortable when they ask the question.
“Can you help me fill these out?”
For many clinicians, the request lands at the worst possible time. The waiting room is full. The schedule is already behind. And the forms themselves are long, repetitive, and often confusing. Still, you try to …
Why your patient’s disability claim was denied
OpenAI’s announcement of ChatGPT Health landed with predictable shock across health care. A consumer platform with hundreds of millions of users can now securely ingest medical records, wearable data, and personal health history to deliver context-aware guidance in real time. For many health executives, the instinctive response was alarm, but that reaction misses the point.
This announcement was not a disruption; it was a revelation. When OpenAI reports that 230 million …
How ChatGPT Health exposes the flaws in modern primary care
When my medically complex son Declan came home from the hospital, he needed round-the-clock care, 24 hours a day, 365 days a year. A full-time worker puts in about 1,960 hours a year, assuming 40 hours a week minus vacation and holidays. Each year has 8,760 hours. That means caring for Declan required an equivalent of 4.47 full-time employees every year.
In Minnesota, where we live, for even the highest-acuity cases, …
Pediatric home health care oversight: Why accountability is failing
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