How many times have we accelerated something by using our connections? Instead of days, a scan was approved in a matter of hours. A call that puts a loved one on the waiting list. A coworker who discreetly "looks" before a meeting is scheduled. Although these incidents are rarely dramatic, they highlight a basic truth about medicine: those who understand the system can work within it, while those who don't have to endure it.

The majority of physicians do not consider it to be a misuse of privilege. We believe it shields the people we love from a system we no longer completely trust. Too many patients have fallen through the cracks, too many delays have occurred, and too many mistakes have been prevented. Neutrality feels like neglect when it comes to our own family. We therefore take action because we are unable to bear the risks we are too familiar with, not because we wish to gain an advantage.

That ability to "move the system" comes with a hidden price. Each favor granted only deepens the divide - separating those who have access from those who don’t. It might not be corruption in the usual sense, but it still undermines fairness. The more we depend on personal connections to make care feel human, the more we reinforce the idea that true humanity isn't woven into the system itself.

There's no ill intent behind it. Most of us operate on instinct rather than arrogance. We've all witnessed how minor delays can spiral into major crises. We've seen good people struggle because a system is too slow, too congested, or too oblivious. So when it hits close to home, we take action. And perhaps that's what complicates things - it stems from love, not entitlement. Yet, every time we step in, we’re reminded that so much of medicine hinges on connections, not just on what you actually need. It's not documented anywhere, but it's very real - an unseen web of favors and understanding that keeps everything flowing. It works like a charm when you're part of it, and painfully when you're left out.

Medicine has always wrestled with its central purpose. Is it defined by the pursuit of cure-eradicating disease, extending life, and restoring function-or is it equally, if not more, about relieving suffering, even when cure is impossible? This question has resurfaced in modern practice, especially as physicians encounter chronic illnesses, aging populations, and end-of-life care. The balance between cure and comfort lies at the very heart of our profession.

The historical roots of medicine suggest that both cure and relief of suffering were always present. Hippocrates emphasized  "to cure sometimes, to relieve often, to comfort always." This aphorism captures an enduring truth: medicine cannot promise cures for every condition, but it can promise compassion and relief. The physician's role is not diminished by the impossibility of cure; it is transformed. A doctor who cannot cure still carries immense responsibility to heal in another sense-through alleviation of pain and the preservation of dignity.

Research reinforces the importance of this dual mission. A 2019 systematic review on patient priorities in healthcare found that quality of life and relief from pain often ranked as highly-or higher-than clinical outcomes like survival. Patients facing cancer, for example, reported valuing the ability to spend meaningful time with family more than aggressive treatments that offered little extension of life. These insights challenge a cure-centric model and remind physicians that suffering is not only physical but also existential, social, and spiritual.

Palliative care illustrates this balance most vividly. Studies have shown that integrating palliative care early in serious illness not only improves quality of life but can also extend survival in some cases. One landmark 2010 trial in the New England Journal of Medicine found that patients with metastatic lung cancer receiving early palliative care lived longer than those receiving standard oncologic treatment alone. This paradox-that focusing on relieving suffering may sometimes extend life-undercuts the false dichotomy between cure and comfort.

Yet modern medicine often leans heavily toward cure, sometimes at the expense of the patient's broader well-being. The proliferation of high-cost technologies, experimental therapies, and aggressive interventions in ICUs may prolong life but can also prolong suffering. Ethical debates arise: are we treating the disease, or the person living with the disease? Physicians must constantly navigate the tension between offering every possible medical option and recognizing when the most humane option is to relieve suffering rather than chase cure.

From the physician's perspective, this dilemma is also deeply personal. Many doctors struggle with the feeling of failure when a patient cannot be cured. But reframing success as alleviating pain, supporting families, and respecting patient values shifts the narrative. The physician's role is not measured solely by survival curves or tumor shrinkage, but by whether the patient feels seen, heard, and relieved of unnecessary suffering. This broader definition of healing offers doctors themselves a more sustainable and humane professional identity.

Ultimately, medicine is not an either/or between cure and comfort-it is both, depending on context. In acute infections, fractures, or reversible conditions, cure may rightly be the priority. In chronic illness, terminal diagnoses, or conditions resistant to therapy, relieving suffering takes precedence. What unites both roles is the doctor's fidelity to the patient's well-being. As Osler reminded us, "The good physician treats the disease; the great physician treats the patient who has the disease." Perhaps the true role of medicine is not to choose between cure and comfort, but to integrate them as inseparable dimensions of healing.

The landscape of modern medicine has always evolved with science, technology, and social change. But in 2025, the most aggressive force reshaping healthcare delivery has been political. This year, physicians worldwide have felt a tightening grip of political authority around their clinical autonomy. From reproductive care to mental health access, from Vaccine distribution to gender-related treatment policies, medicine is increasingly at the mercy of lawmakers. These aren't peripheral issues-they're core matters of patient care, ethics, and scientific integrity. The medical community is now reckoning with a difficult truth: politics is no longer outside the clinic; it's in the room with the patient.

In the United States, legislative battles around abortion have reached new levels of complexity. Since the fall of Roe v. Wade, over a dozen states have passed or expanded laws that criminalize doctors for performing or even recommending certain reproductive procedures, even in medically urgent situations. In 2025, several high-profile cases have shown physicians facing prosecution for providing standard miscarriage management or ectopic pregnancy care. The legal environment is now so precarious that hospitals in restrictive states often delay critical care while waiting for legal teams to weigh in. This creates moral distress for physicians, many of whom now practice in constant fear of lawsuits or even arrest-just for doing what they were trained to do.

Outside the U.S., similar trends are unfolding. In parts of Latin America and Eastern Europe, governments have tightened control over what is considered "acceptable" reproductive care, often under the guise of protecting national values or traditional family structures. Physicians in countries like Hungary and El Salvador report mounting pressure to withhold information or restrict access to contraception and abortion, even when it goes against clinical guidelines. Meanwhile, international NGOs trying to provide comprehensive reproductive health services are being blocked or defunded. These constraints have created a two-tiered healthcare system-one for those with means to travel and another for those left behind.

One of the most heated and politically charged areas in 2025 has been gender-affirming care. Several countries have enacted legislation banning or severely limiting this type of care for minors, while others are placing restrictions on adult services as well. As doctors, we're taught to respect patients and evidence-but this issue has become increasingly fraught. Some physicians, myself included, have genuine concerns about the long-term impacts of hormone therapy and surgical interventions in adolescents. We've seen cases where patients later regret transitioning or feel they were rushed into decisions without adequate psychological assessment. These concerns are not rooted in hatred, but in caution, ethics, and a responsibility to "do no harm." Yet raising such concerns today often leads to accusations of bias or professional misconduct. Political and institutional forces seem determined to silence even respectful debate within the medical field, leaving many physicians to navigate these dilemmas quietly, without guidance or support.

The politicization of public health has also disrupted our ability to respond effectively to infectious disease outbreaks. In several countries, Vaccine programs have stalled due to partisan interference. In India, for instance, regional governments have delayed the rollout of a new dengue Vaccine due to internal power struggles, despite surging infection rates. In the U.S., routine childhood vaccination rates continue to decline, fueled by political figures who cast doubt on their safety or necessity. Physicians are once again in the position of defending settled science in the face of misinformation, while battling mistrust from patients who view every public health recommendation as a political statement.

Another major impact of politics this year has been on mental health funding and policy. In the wake of post-COVID burnout, economic strain, and social polarization, demand for mental health services has skyrocketed. Yet several governments-particularly in the UK, Italy, and Australia-have cut funding for public mental health programs as part of broader austerity agendas. In practice, this has left general practitioners, emergency room physicians, and pediatricians scrambling to manage complex psychiatric cases without adequate support. Waiting lists have ballooned. Suicide rates have risen in several countries. And physicians are increasingly asked to take on roles they are not fully trained for, simply because the systems meant to support them are collapsing under political pressure.

Even international medical collaboration has suffered. Geopolitical tensions, especially among NATO, BRICS, and non-aligned states, have made global health data harder to access. Projects on infectious disease surveillance, antibiotic resistance, and climate-related health threats have stalled due to nationalism and protectionism. Several governments are now blocking cross-border data sharing unless certain political conditions are met. This slows response time during outbreaks, stifles innovation, and undermines trust among health professionals who once relied on international cooperation to advance their work.

Ultimately, what 2025 has taught us is that medicine cannot remain insulated from politics. Whether we like it or not, our clinical decisions, patient relationships, and professional obligations are now being shaped by external forces-sometimes subtly, sometimes overtly. Physicians must adapt to this new reality. We must stay informed, protect our ethical ground, and advocate where needed. And we must find ways to voice dissent, even within a system that increasingly prefers compliance. The health of our patients-and the integrity of our profession-depends on it.

WEDNESDAY, May 29, 2024 (HealthDay News) -- From 2007 to 2019, there was an increase in inflation-adjusted health care spending, largely due to increasing contributions to premiums, according to a research letter published online May 28 in JAMA Internal Medicine.

Sukruth A. Shashikumar, M.D., from the Beth Israel Deaconess Medical Center in Boston, and colleagues conducted a cross-sectional study using 2007 to 2019 Medicare Expenditure Panel Survey data for respondents and family members younger than 65 years with private insurance to understand changes in the financial burden of health care. Families' total health care spending was calculated as a contribution of premiums plus out-of-pocket medical and prescription drug spending; annual financial medical burden was assessed by dividing their total health care spending by postsubsistence income.

The unweighted sample included 96,075 families and the mean annual weighed population included 83,523,039 families. The researchers observed an increase in inflation-adjusted mean total health care spending from $3,920 to $4,907, mainly due to an increase in contributions to premiums. The financial medical burden was 8.4 and 9.8 percent of postsubsistence income in 2007 and 2019, respectively. Mean total health care spending was $3,163 and $3,247 in 2007 and 2019, respectively, for low-income families, and their medical burden was 23.5 and 26.4 percent, respectively. Among higher-income families, the corresponding mean total health care spending was $4,071 and $5,239 and medical burden was 5.4 and 6.5 percent in 2007 and 2019.

"Our findings highlight the need to strengthen financial safeguards for low-income families," the authors write.

One author disclosed ties to a health insurance company; a second author disclosed ties to the pharmaceutical industry.

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Our system must better balance profits with the needs of patients.

I'm the only physician in the emergency room. There are still several patients to see. The waiting room is overflowing, and the mountain of paperwork grows. I know there are consequences if I don't document what I've done, what I've seen, thought, heard, and who I've talked to. But then a patient's family member knocks on the door and says "Doc, can we talk about my mom? I'm worried."I want to talk with this person. I want to talk about her mom's prognosis and how her family should prepare. But I have other patients, and that mountain of paperwork keeps nagging at my subconscious. I speak with her, but I'm in a rush. She senses that. She is upset. But so am I. This family doesn't feel like I've listened to them. And it's extremely important that I do -- for the sake of their mother's health, but also for my mental well being as a caregiver.

The simple act of taking time and listening is one of the most important components of patient care. But as physicians we feel we do not have time to listen, much less harness and demonstrate compassion. According to a University of Chicago study from last year, it would take a primary care physician 26.7 hours per day to provide complete, guideline-based care for their average number of patients. These facts have consequences. Patients believe that healthcare systems put profit over patients.Healthcare workers enter the field to help patients. And patients expect us to help them. They want to be heard. They want us to listen. They want to be treated equitably, with compassion, and ultimately, to feel better. Compassionate care involves acknowledging the emotional distress and suffering of others, along with acting to improve their situation through motivation and relational efforts. Many physicians and nurses attribute burnout to the increasing corporatization of medicine, where companies prioritize "profits over patients."...Read more

Do you feel that capitalism and compassion are at odds? Does the need for profit hinder your care of patients? 

TUESDAY, Jan. 10, 2023 (HealthDay News) -- Low-value prostate cancer screening is common in primary care, according to a study published in the January issue of the Journal of the American Board of Family Medicine.

Chris Gillette, Ph.D., from the Wake Forest School of Medicine in Winston-Salem, North Carolina, and colleagues used data from the National Ambulatory Medicare Care Survey (2013 to 2016 and 2018) to assess the proportion of U.S. primary care visits at which low-value prostate cancer screening is ordered, as well as characteristics associated with low-value prostate cancer screening.

The researchers found 6.71 low-value prostate-specific antigens (PSAs) per 100 visits and 1.65 low-value digital rectal exams (DREs) per 100 visits. The odds of ordering a low-value PSA increased by 49 percent and the odds of performing a low-value DRE increased by 37 percent for each additional service ordered by primary care providers.

"As health care systems move toward a more value-based care system -- where the benefit of services provided outweighs any risks -- providers need to engage patients in these discussions on the complexity of this testing," Gillette said in a statement. "Ultimately, when and if to screen is a decision best left between a provider and the patient."

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WEDNESDAY, May 24, 2023 (HealthDay News) -- Weekend catch-up sleep among postmenopausal women is associated with a decreased prevalence of hyperuricemia, according to a study published online May 16 in Menopause.

Soo Min Son, M.D., from the Family Medicine Clinic and Research Institute of Convergence of Biomedical Science and Technology at Pusan National University Yangsan Hospital in South Korea, and colleagues investigated the relationship between weekend catch-up sleep and hyperuricemia among 1,877 postmenopausal women.

The researchers found that women with weekend catch-up sleep had a significantly lower prevalence of hyperuricemia when adjusting for confounders (odds ratio, 0.758). Weekend catch-up sleep of one to two hours was significantly associated with a lower prevalence of hyperuricemia in an adjusted analysis (odds ratio, 0.522).

"Elevated serum uric acid levels are associated with multiple cardiovascular disease risk factors, whereas sufficient, good-quality sleep has proven health benefits," Stephanie Faubion, M.D., medical director of the North American Menopause Society, said in a statement. "This study shows that weekend catch-up sleep of just 1 to 2 hours was linked with a lower prevalence of hyperuricemia in postmenopausal women with insufficient sleep. Although the mechanisms responsible for these findings remain unclear, a weekend nap may be just what the doctor ordered."

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FRIDAY, Jan. 26, 2024 (HealthDay News) -- Monoclonal antibodies targeting amyloid provide small benefits on cognitive and functional scales, which do not meet the minimal clinically important difference, according to a review published in the January/February issue of the Annals of Family Medicine.

Mark H. Ebell, M.D., from the University of Georgia in Athens, and colleagues conducted a meta-analysis to evaluate clinically meaningful benefits and harms of monoclonal antibodies targeting amyloid in patients with Alzheimer dementia. Nineteen publications with 23,202 total participants that examined eight anti-amyloid antibodies were identified.

The researchers identified small improvements over placebo in the Alzheimer's Disease Assessment Scale-Cog-11 to -14 score, Mini Mental State Examination score, and Clinical Dementia Rating-Sum of Boxes scale score, as well as the combined functional scores. None of the changes exceeded the minimal clinically important difference, including lecanemab, aducanumab, and donanemab. Significantly increased risks for amyloid-related imaging abnormalities (ARIA)-edema (relative risk [RR], 10.29), ARIA-hemorrhage (RR, 1.74), and symptomatic ARIA-edema (RR, 24.3) were identified as harms (number needed to harm: nine, 13, and 86, respectively).

"Our meta-analysis shows that monoclonal antibodies targeting amyloid do not provide a clinically meaningful benefit, are associated with significant harms, and come at a high cost," the authors write.

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WEDNESDAY, Feb. 21, 2024 (HealthDay News) -- In a ruling that could drastically limit future infertility care, the Alabama Supreme Court has ruled that frozen embryos can be considered children under state law.

In the decision, judges turned to what it called anti-abortion language in that state's constitution and concluded that an 1872 state law that allows parents to sue over the death of a minor child “applies to all unborn children.”

“Unborn children are ‘children’ ... without exception based on developmental stage, physical location, or any other ancillary characteristics,” Associate Justice Jay Mitchell wrote in the ruling.

Reaction to the decision was swift and strident, as infertility experts stressed the ruling ultimately threatens the use of IVF treatments.

“By insisting that these very different biological entities are legally equivalent, the best state-of-the-art fertility care will be made unavailable to the people of Alabama. No health care provider will be willing to provide treatments if those treatments may lead to civil or criminal charges,” Dr. Paula Amato, president of the American Society for Reproductive Medicine, told the Associated Press.

“This ruling is stating that a fertilized egg, which is a clump of cells, is now a person. It really puts into question the practice of IVF,” Barbara Collura, CEO of RESOLVE: The National Infertility Association, told the AP.

The decision is a “terrifying development for the 1-in-6 people impacted by infertility” who need in-vitro fertilization, she said.

Following the ruling, it isn't clear whether future embryos created during fertility treatments can be frozen or if patients could ever donate or destroy unused embryos.

But Sean Tipton, a spokesman with the American Society for Reproductive Medicine, told the AP that at least one Alabama fertility clinic has been instructed by their affiliated hospital to pause IVF treatment for now.

The plaintiffs in the Alabama case had IVF treatments that created several embryos, some of which were implanted and led to healthy births, the AP reported. The couples paid to keep the unused embryos frozen in a storage facility, but a patient managed to wander into the area in 2020 and removed several embryos, dropping them on the floor and “killing them,” the ruling said.

The justices ruled that the wrongful death lawsuits brought by the couples could proceed, although the clinic and hospital named as defendants in the case could appeal.

Michael Upchurch, a lawyer for the fertility clinic in the lawsuit, the Center for Reproductive Medicine, told the AP they are “evaluating the consequences of the decision and have no further comment at this time.”

Meanwhile, an anti-abortion group applauded the decision.

“This ruling, which involved a wrongful-death claim brought by parents against a fertility clinic that negligently caused the death of their children, rightly acknowledged the humanity of unborn children created through in vitro fertilization [IVF] and is an important step towards applying equal protection for all,” Lila Rose, president and founder of Live Action said in a statement.

Justice Greg Cook, who filed the only full dissent to the ruling, said the 1872 law was being stretched from its original intent to cover frozen embryos.

“No court -- anywhere in the country -- has reached the conclusion the main opinion reaches,” he wrote, adding the ruling “almost certainly ends the creation of frozen embryos through in vitro fertilization [IVF] in Alabama.”

White House press secretary Karine Jean-Pierre said Tuesday that the Alabama decision was yet another consequence of the U.S. Supreme Court overturning Roe v. Wade in June 2022, the AP reported.

“This president and this vice president will continue to fight to protect access to reproductive health care and call on Congress to restore the protections of Roe v. Wade in federal law for all women in every state,” Jean-Pierre told reporters.

More information

The World Health Organization has more on abortion.

SOURCE: Associated Press

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Fierce Healthcare

Nearly a quarter of physicians reported clinical depression in a new survey, while 9% admitted to suicidal thoughts, and 1% shared that they attempted to end their lives.9,100 physicians across 29 specialties were surveyed last year. While physicians often address the suicide crisis throughout the U.S., many are struggling with their own mental health. Two-thirds of doctors reported colloquial depression, according to the survey. Twenty-four percent of doctors reported clinical depression, and the survey also found that doctors are more likely to have suicidal thoughts compared to those in other professions.

Depression in the medical community has been a serious problem for about as long as it has been measured, Andrea Giedinghagen, M.D., assistant professor of psychiatry at the St. Louis Washington University School of Medicine, said in the report. “Physicians are also still coping with a pandemic—the trauma from COVID-19 didn’t disappear just because the full ICUs did—and with a fractured healthcare system that virtually guarantees moral distress,” Giedinghagen said. “This is beyond individual solutions for individual problems. Systemic change is necessary.”Younger physicians were more likely to say that a med school or healthcare organization should be responsible for a student or physician’s suicide. Of those aged 42 to 56 years, 57% were unsure whether institutions should bear any responsibility.

When it comes to specialty, the top five specialist types most likely to report suicidal thoughts were otolaryngology, psychiatry, family medicine, anesthesiology and OB-GYN. The five specialist types least likely were orthopedics, nephrology, oncology, rheumatology and pulmonary medicine...Read more

Who should be responsible for dealing with this issue?

For people with alcohol use disorder (AUD), there is a constant, vicious cycle between changes to the brain and changes to behavior. AUD can alter signaling pathways in the brain; in turn, those changes can exacerbate drinking.

Now, scientists at Scripps Research have uncovered new details about the immune system's role in this cycle. They reported that the immune signaling molecule interleukin 1β (IL-1β) is present at higher levels in the brains of mice with alcohol dependence. In addition, the IL-1β pathway takes on a different role in these animals, causing inflammation in critical areas of the brain known to be involved in decision-making.

"These inflammatory changes to the brain could explain some of the risky decision-making and impulsivity we see in people with alcohol use disorder," says senior author Marisa Roberto, Ph.D., the Schimmel Family Chair of Molecular Medicine and a professor of neuroscience at Scripps Research. "In addition, our findings are incredibly exciting because they suggest a potential way to treat alcohol use disorder with existing anti-inflammatory drugs targeting the IL-1β pathway." Drugs that block the activity of IL-1β are already approved by the U.S. Food and Drug Administration to treat rheumatoid arthritis and other inflammatory conditions...Read More

Will this information change the way you counsel your patients about alcohol use disorder?

The New York Times

The best use for generative A.I. in health care, doctors say, is to ease the heavy burden of documentation that takes them hours a day and contributes to burnout.

Dr. Matthew Hitchcock, a family physician in Chattanooga, Tenn., has an A.I. helper. It records patient visits on his smartphone and summarizes them for treatment plans and billing. He does some light editing of what the A.I. produces, and is done with his daily patient visit documentation in 20 minutes or so. Dr. Hitchcock used to spend up to two hours typing up these medical notes after his four children went to bed. “That’s a thing of the past,” he said. “It’s quite awesome.”

ChatGPT-style artificial intelligence is coming to health care, and the grand vision of what it could bring is inspiring. Every doctor, enthusiasts predict, will have a superintelligent sidekick, dispensing suggestions to improve care. But first will come more mundane applications of artificial intelligence. A prime target will be to ease the crushing burden of digital paperwork that physicians must produce, typing lengthy notes into electronic medical records required for treatment, billing and administrative purposes. For now, the new A.I. in health care is going to be less a genius partner than a tireless scribe. Medicine, doctors emphasize, is not a wide open terrain of experimentation. A.I.’s tendency to occasionally create fabrications, or so-called hallucinations, can be amusing, but not in the high-stakes realm of health care...Read more

Are you excited for the day AI becomes your superintelligent sidekick or prefer AI as a tireless scribe?

The COVID-19 pandemic had a transient negative effect on breast cancer screening overall and a prolonged negative effect on follow-up screening, according to a study published in the May/June issue of the Annals of Family Medicine.

Andrew Chung, from Pennsylvania State University in University Park, and colleagues evaluated the pandemic's impact on overall and follow-up breast cancer screening using real-world health records data from the TriNetX Research Network. The analysis included 1.19 million women eligible for breast cancer screening from Jan. 1, 2017, to Feb. 28, 2022.

The researchers found that the monthly screening volume temporarily decreased by 80.6 percent from February to April 2020 and then rebounded to close to pre-COVID levels by June 2020. The follow-up screening rate decreased from 78.9 percent in the pre-COVID period to 77.7 percent in the COVID period. The COVID period also had a lower adherence to follow-up screening (odds ratio, 0.86), with a greater pandemic impact among women aged 65 years and older and women of non-Hispanic "other" race (Asian, American Indian or Alaska Native, and Native Hawaiian or Other Pacific Islander).

"As health systems around the world start to recover from the disruptions in essential health services after three years of the pandemic, innovative care navigation strategies, such as focused outreach efforts, are needed to close the gap and improve the stagnant breast cancer screening rate, adherence rate, and outcomes," the authors write.

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An internationally trained doctor in Regina is leaving Canada after seven years of being unable to secure his medical licence to practise.Ken Katas arrived in Canada with his family in 2015 after he heard there was a need for doctors. “I thought it was a good opportunity for me to continue my medical practice in Canada,” said Katas. “I had high hopes.” That hope was met with disappointment. He said he took the medical qualifying exam three times, yet he was unable to pass. He said he is not alone. “They are many people like me, and many people that have also passed the qualifying exam, and yet they don’t have a placement,” Katas said.

A placement in the Saskatchewan International Physician Practice Assessment (SIPPA) ensures that internationally trained physicians possess adequate clinical skills and knowledge to practice medicine in Saskatchewan. The SIPPA medical director stated there are more applicants than available places.

Katas said at one time, eight doctors including himself wrote the qualifying exams when six of them passed but none of them got a placement in SIPPA. “Now they have all moved to (the) United Kingdom and Australia to practice,” Katas said.No matter how urgently Canada needs Doctors, Witt believes things must be done properly and safely. “We need to do it in a way that is safe, patients and the people of Canada expect that their doctor is knowledgeable skilled and understands how the system works,” Witt said...Read more

Should the process stay the same or change?

Female physicians experience greater earnings penalty due in part to marriage, children.Previous studies have shown that female physicians earn less than their male counterparts, so we wanted to investigate the impacts of marriage and children on the gap in female physician earnings.

The retrospective, cross-sectional study included 95,435 physicians who responded to the American Community Survey between 2005 and 2019. Researchers assessed gaps in earnings and hours according to sex by calculating family status and physician age. Main outcomes included annual earned income, usual hours worked per week and earnings per hour worked. Results showed that female physicians appeared more likely to be single (18.8% vs. 11.2%) and less likely to have children (53.3% vs. 58.2%) when compared with their male counterparts. Researchers observed a female-male earnings gap among those aged 25 years to 64 years of approximately $1.6 million for single physicians, $2.5 million for married physicians without children and $3.1 million for physicians with children. Male physicians earned between 21.4% and 23.9% more per hour than female physicians.

“These findings did not surprise me. As a woman in medicine, I have encountered the way that structural sexism operates within the medical education system. However, I was surprised by the magnitude of disparity in earnings. On average, female physicians with children earn more than $3 million less than their male counterparts throughout their careers.”...Read More

Have you observed discrepancies in career advancement opportunities for male and female physicians?  

Binge-eating disorder (BED) does improve over time; however, remission often takes many years, according to a study published online May 28 in Psychological Medicine.

Kristin N. Javaras, Ph.D., from McLean Hospital in Belmont, Massachusetts, and colleagues examined changes in BED diagnostic status in a prospective, community-based study. The analysis included probands and relatives with a current diagnosis of BED (156 participants) from a family study of BED with follow-up at 2.5 and five years.

The researchers found that at 2.5 years, 61.3 percent showed full BED, 23.4 percent showed subthreshold BED, and 15.3 percent showed no BED; the corresponding values at five years were 45.7, 32.6, and 21.7 percent. At follow-up, no participants displayed anorexia or bulimia nervosa. Median time to remission (no BED) was >60 months, while median time to relapse (subthreshold or full BED) after remission was 30 months. Using baseline demographic and clinical variables, two classes of machine learning methods did not consistently outperform random guessing at predicting time to remission.

"As a clinician, oftentimes the clients I work with report many, many years of binge-eating disorder, which felt very discordant with studies that suggested that it was a transient disorder," Javaras said in a statement. "It's very important to understand how long binge-eating disorder lasts and how likely people are to relapse so that we can better provide better care."

Several authors disclosed ties to the pharmaceutical industry.

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As scorching summer temperatures drive Americans indoors and millions travel for vacations and family gatherings, COVID infections are again climbing, U.S. health officials warned Monday.

In evidence that suggests a COVID summer wave is underway, case counts are most likely increasing in 39 states and aren’t declining anywhere in the country, new data from the U.S. Centers for Disease Control and Prevention show.

While the CDC no longer tracks COVID cases, it still estimates spread of the virus using data on emergency department visits. Both COVID deaths and emergency department visits have risen in the last week, while hospitalizations climbed 25% from May 26 to June 1, according to the latest CDC data.

“It looks like the summer wave is starting to begin,” Dr. Thomas Russo, chief of infectious diseases at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences, told NBC News.

Several new COVID variants are likely contributing to the summer spike in cases, Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, told NBC News.

“We’re seeing the start of an uptick of infections that is coincident with new variants that are developing: KP.2 and KP.3 and LB.1. It does appear that those variants do have an advantage over the prior ones,” he added.

All three variants are descendants of JN.1, the version of the coronavirus that dominated this winter.

KP.2 became the dominant variant last month, and then KP.3 took over in early June, NBC News reported. Along with a third variant that shares the same key mutations, KP.1.1, the group now accounts for around 63% of all COVID infections in the United States, CDC data show.

Meanwhile, LB.1 accounts for another 17.5% of COVID infections. Experts said its rapid growth indicates that it’s likely to become dominant soon.

Still, “it’s sort of the newest kid on the block,” Barouch said. “There’s not much known about it.”

A preprint study released this month, which hasn’t yet been peer-reviewed, suggests LB.1 is more infectious and could be better at evading protection from vaccines or previous infections.

“Assuming that preliminary data is true, that it’s more immune-evasive and that it’s more infectious than KP.2 and KP.3, that’s a winning formula to infect more people,” Russo noted.

Apart from variants, experts said cases will probably continue to rise as people retreat indoors to escape the heat and gather to celebrate the Fourth of July.

Russo recommended that people who are vulnerable to infection and severe illness, or who are more likely to attend large parties or gatherings, consider getting the latest COVID vaccine.

He added that a monoclonal antibody drug called Pemgarda has been available since April for immunocompromised people. The antiviral medication Paxlovid can also lower the likelihood of hospitalization or death.

As for young, healthy people, they can hold out for the updated COVID vaccines expected to arrive this fall, experts said.

This month, the U.S. Food and Drug Administration advised vaccine manufacturers to target the KP.2 variant. The CDC’s Advisory Committee on Immunization Practices is set to meet Thursday to decide who should get those shots.

More information

The CDC has more on COVID vaccines.

SOURCES: U.S. Centers for Disease Control and Prevention, data, June 24, 2024; NBC News

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I moved to Ontario, Canada, a little less than a year ago, with a sense of adventure and a spring in my step. I was excited at the thought of being reunited with family, apprehensive about the hurdles in my path to becoming a practicing physician, but hopeful that there would be light at the end of the tunnel. There had to be.

I had been chief resident at an ACGME-accredited four-year emergency medicine program, where I had the privilege of being taught by, and later working alongside, some brilliant emergency physicians from all over the world (including Canada). I had worked in JCI-accredited hospitals and had nearly ten years of experience in both public and private practice. I was (am?) a board-certified emergency physician in the Middle East. However, after immigrating to Canada, the caduceus around my neck is the only reminder of what once was.

And I’m not alone. According to an article published by the CBC in February 2023, “as many as 13,000 medical doctors in Canada who are not practicing because they haven’t completed a two-year residency position — a requirement for licensing.” Even those who have completed the residency requirements, regardless of their background and experience, have to perhaps go through residency one more time because the last time it wasn’t in Canada. Still, they have the odds stacked against them when participating in the Canadian Residency Matching Service (CaRMS). In the 2020 R1 Match, Canadian and U.S. medical graduates had a 97.7 percent match rate, while international medical graduates (IMGs) only had a match rate of less than 23 percent. Even the specialties available to IMGs are limited to only a handful, while for Canadian medical graduates, Canada is their oyster...Read more

Do you think it should be easier for internationally trained physicians to practice in Canada?