Human cognition has always been a negotiation or even battle between imagination and experience. We build models and then we test them. We get things wrong, learn, and rejigger against the facts of the real world. Our intelligence lives in that loop between abstraction and embodiment. AI has no loop. It never leaves the page. When a model falters because of a stray phrase—say, when the simple addition of “cats sleep for most of their lives” triples its error rate.  Now, let’s be clear, that’s not confusion, it’s exposure. The system doesn’t know which parts of language belong to meaning and which don’t. It reads everything as pattern. That’s the curious mirage of AI. It’s the words without the world.  Or should I say map?

Korzybski famous and timeless quote was about humans, not machines. He warned that when we mistake a symbol for the thing it represents, we drift toward ambiguity, if not fiction. What’s unsettling now is that we’ve mechanized that ambiguity in the context of AI. We’ve built a technological architecture that embodies it with an odd perfection. And because AI speaks so persuasively, we start to believe it. A generated paragraph about empathy can feel like empathy itself. And a simulated diagnosis can feel like understanding. The danger isn’t deception, it’s equivalence. So, remember, the algorithm doesn’t lie, it just neither knows nor cares.

So, if AI lives in the map, then we remain the territory. The goal isn’t to merge the two but to hold them in tension. That distance—between representation and reality—is where depth arises. I’ve called this parallax cognition: when two distinct forms of knowing observe the same problem from different vantage points. The difference creates critical dimensionality. Consider AlphaFold, the AI that predicted protein structures. It recognized patterns invisible to us, but the discovery only mattered once human scientists interpreted what those patterns meant in biological terms. That’s parallax in action. AI sees the map and we walk the ground. Together, but distinct, we generate insight neither could reach alone.

There’s a fair question that’s often raised: If it works, does it matter how? For translation, maybe not, for navigation, perhaps less. But in meaning-dense domains like medicine, ethics, and fine art, how it works is the difference between simulation and understanding. AI’s competence can mask its detachment and the map can be dazzling enough that we forget it isn’t the journey.

Anti-intelligence isn’t a flaw, it’s the logical endpoint of symbol-based reasoning. It represents the perfection of the map and the potential elimination of the territory. Korzybski’s century-old warning is resonant today.  Once our abstractions become too beautiful, we start living inside them. AI has given us the most complete map humanity has ever drawn. The challenge is to stay grounded and to make sure the map still serves our earth beneath it.

The post Anti-Intelligence: The Map That Forgot the Territory appeared first on Medika Life.

This is the arc: Person > Time > Physician. Not a cycle of regression, but of reinvention.

Phase One: The Person at the Center

The roots of modern medicine were personal. The physician was a familiar figure—a generalist who treated generations within a single household. Medicine was relational, grounded in trust, and delivered with a deep sense of continuity. Perhaps reflective of Life Magazine’s 1948 article about “The Country Doctor” described in the story as “chronicling the day-to-day challenges faced by an indefatigable general practitioner named Dr. Ernest Ceriani.”

Diagnoses came as much from conversation as from tests. The clinician listened first, treated second, and followed the arc of a life over the years. Care in this phase wasn’t perfect. It lacked the diagnostic precision and computational power of today. But it was holistic and even economical, or at least tried to be. It honored the complexity of the person, not just the pathology.

Phase Two: Time as a Dominant Force

As medicine scaled and systems matured, priorities shifted. The explosion of specialization, regulatory oversight, and insurance complexity transformed the clinical encounter. Time—finite, quantifiable, and billable—became the axis around which care revolved. The physician’s role narrowed. The 10-minute visit became the norm. Clicks replaced eye contact. Patients became entries in digital fields, and clinicians became overburdened intermediaries between policy and protocol.

Technology, introduced with the promise of efficiency, often had the unintended consequence of distancing the doctor from the patient. In this era, quality wasn’t often measured in trust or presence, but in throughput and compliance.  And perhaps most importantly, often counter to the desires of both patients and clinicians.

Phase Three: The Return of the Physician—Reimagined

And yet, here we are again, on the edge of a new transformation. Surprisingly, it’s not nostalgia driving the shift, but innovation. The very technologies that once fragmented care may be offering a path back to the human core of medicine.

Artificial intelligence, automation, predictive analytics, and remote monitoring aren’t here to replace the physician. They’re here to liberate them. These tools offload the administrative weight, surface meaningful patterns, and support decision-making. They create space—cognitive, emotional, and temporal—for the physician to re-enter the room fully present.

This isn’t a return to the physician of the 1940s, but the emergence of something new and discover a digitally enabled, intellectually unburdened clinician who has time to think, listen, and connect. 

We’re Not Going Back—We’re Going Forward, Differently

The arc of care doesn’t circle back—it spirals forward. Today’s renaissance of the physician isn’t about nostalgia. It’s about design. About recognizing that the highest expression of technology in medicine is not automation, but amplification of the human.

This is physician-centered care, powered by artificial intelligence and yielding the much sought-after patient-centered dynamic. It’s a model where AI works in the background, allowing the clinician to lead with insight and empathy. Patients are known not just by their labs but by their lives.

A Full-Circle Revolution

So here we are—completing the arc. From person to time to physician. The system that once de-centered the doctor is now making space for their return—not because we missed them, but because we need them. And not as clerks or data jockeys—but as guides, partners, and thinkers.

The future of medicine may be high-tech, but it is also can be—once again—deeply human.

The post Back to the Future of Medicine: The Physician Reimagined appeared first on Medika Life.

But even outside of cancer, some conditions can quietly — but powerfully — erode the quality of life.

Gastroesophageal reflux disease (GERD) is one of them.

I’ve had countless conversations with patients who struggle with it — some who downplay the impact until it starts interrupting their sleep, their meals, and even their voices.

That’s why I paid attention when comedian Kenan Thompson opened up about his battle with GERD.

Kenan and SNL

For most of us, Kenan is known for his effortless humor and long-running role on Saturday Night Live.

But behind the scenes, he’s been wrestling with a chronic condition that doesn’t exactly pair well with live performance.

GERD, which occurs when stomach acid repeatedly flows backward into the esophagus, has the power to sap your energy, inflame your throat, and leave you hoarse when your voice matters most.

He recently shared this:

“When it’s at its worst, it definitely can cause me to be hoarse a lot faster than I’d expect.”

He even uses singing to warm up before a show — his barometer of vocal health.

And when the reflux flares up, he knows he’s in trouble.

Kenan’s Story

Behind the scenes, the longtime SNL cast member quietly dealt with a health issue that was anything but funny.

For nearly two years, Thompson struggled with persistent symptoms that gradually took a toll on his voice, his sleep, and his well-being.

He shared his symptoms in a recent interview:

“I started noticing that I was losing my voice more quickly during the show. It was frustrating — I’d be hoarse faster than expected, and my nights were restless. I’d be burping up acid, hiccuping through the night.”

At first, he brushed it off.

A little discomfort here, a rough night there — it didn’t seem like something worth fussing over.

“I kept thinking, I’ll get through it. It’ll pass,” Thompson said. “But over time, it just kept adding up.”

Symptoms Worsened

He tried to manage the problem on his own.

Dietary tweaks, a few over-the-counter medications, temporary adjustments.

It helped — for a while.

Thompson admitted:

“Eventually, none of it worked anymore. That’s when I knew it was serious. But I still didn’t talk to anyone about it. I wasn’t embarrassed exactly — I just didn’t know if it was worth bringing to a doctor.”

It wasn’t until early last year, when the symptoms escalated, that he finally made an appointment.

The diagnosis?

GERD — gastroesophageal reflux disease — a condition where stomach acid frequently flows backward into the esophagus, often causing heartburn, sore throats, and disrupted sleep.

For Thompson, the condition had slowly chipped away at his voice, energy, and peace of mind.

And like many people dealing with chronic reflux, he endured it quietly, not realizing just how much it was affecting him until it became impossible to ignore.

Why?

Pizza?

Check.

Sugar-sweetened soda?

Yep.

As his symptoms worsened early last year, he finally sought medical help.

Doctors diagnosed GERD, a common condition in which stomach acid repeatedly flows back into the esophagus, causing irritation and discomfort.

My Clinical Experience

I hear versions of this story all the time in the clinic.

GERD isn’t just heartburn.

It’s the acid that creeps in at night and steals your sleep.

It’s the chronic cough that won’t go away, the sore throat you didn’t see coming, the constant sensation that something’s stuck just behind your breastbone.

And it’s frustrating.

For Kenan, years of trying different treatments led only to temporary relief. “I just got tired of it,” he admitted.

Over-the-counter meds became a short-term bandage — never a real fix.

Lifestyle and GERD

Lifestyle modification is often a good starting point for dealing with GERD.

I often talk with my patients about non-pharmaceutical strategies that can make a real difference:

• Eating smaller meals
• Avoiding food right before bed,
• Elevating the head of the bed to keep acid from creeping upward at night
• Cutting back on trigger foods—think caffeine, alcohol, spicy dishes, and even chocolate.

For some, it’s also about managing stress.

And yes, for others, medications are still part of the equation.

But the first step is recognizing that GERD is more than just an occasional annoyance — it’s a condition that can wear you down, slowly and relentlessly.

Whether you’re a comedian relying on your voice or a patient trying to rest at night, it deserves attention and real solutions.

Kenan’s story isn’t just about reflux. It’s a reminder that health is no laughing matter — even for someone whose job is to make us smile.

Did you know that gastroesophageal reflux disease (GERD) affects up to 30 percent of adults in Western populations and is increasing in prevalence?

GERD can cause pain and increase your risk of developing cancer of the lower esophagus, so if you have concerning symptoms, please see your primary care provider.

A Happy Ending

As for Kenan, after he started taking Voquezna, he felt immediate relief.

The comedian is now partnering with Voquenza’s GERD IS NO JOKE campaign to raise awareness about GERD. In the campaign, he acts as a chef on the “Kick Some Acid Cooking Show.”

And that pizza?

He doesn’t completely avoid his favorite foods, offering this observation:

“There’s balance in it all. I still eat pizza. I just don’t have the same kind of issues because I’m not overdoing it.”

The post Saturday Night Live’s Kenan Thompson’s Health Wake-Up Call appeared first on Medika Life.

Yet today, we find ourselves dismantling these hard-won achievements. Extraordinary cuts to disease prevention, research, and surveillance programs signal a large-scale reversal of a successful strategy of containment and elimination. Such an irresponsible pivot risks opening the door for vaccine-preventable diseases, drug-resistant infections and new pandemics to reemerge with devastating force. If we continue down this path, the consequences will be felt not just in developing nations, but across the industrialized world, where health systems already are under strain.

It could take years to regain the high ground we currently hold against infectious diseases; many countries may never get there again. While pursuing modernization and efficiencies in the global health system is vital, randomly eliminating or suppressing funding and institutions we rely on to develop the pipeline of new vaccines, therapeutics, and practices to fight tomorrow’s pathogens only weakens us further. Our most dangerous disease threats constantly evolve, probe our weaknesses, and exploit natural opportunities to strike.

The attack on America’s preeminent medical research institutions and the innovations they fuel severely undermines our ability to counter disease while degrading the very talent we need to protect us: the next generation of scientists and medical researchers.

Many prominent health leaders are sounding the alarm, but until a coalition of the informed begins to take shape, we may as well be screaming into the wind. Unless a concerted effort is made to change course, the infrastructure, jobs, institutional knowledge, and recruitment of future health experts that constitute one of humanity’s greatest achievements may be dismantled. Surely by now we have learned that research and disease prevention is dramatically less costly than deploying the vast resources necessary to respond to a new outbreak.

Here’s one path forward: U.S. health communicators, advocates, and leaders should coordinate framing the issues to state and congressional lawmakers who stand to lose the most from the current health funding policy direction. Many of the places contributing the most to America’s competitive advantage in biomedical research are in conservative districts that receive funding from the NIH and other public sources.

Similarly, emerging diseases often pose the highest threat to people battling chronic diseases or living in areas underserved by health services, which means all of us are affected, regardless of economic status or ideological belief. People at every level of the health system—from practitioners to patients, researchers to drugmakers—should be energized to speak with one voice and let policymakers know that retreat in the face of defeatable disease threats is the wrong direction for the U.S.

Disease is humanity’s greatest enemy, and it constantly hovers at our doorstep. Do we pretend not to hear it knocking, or do we recognize its dangers and act?

That’s exactly the moment we are facing now. Our situation is complicated by the fact that our most important defenses – biomedical research and disease prevention infrastructure – are being demolished before our eyes. It will take real courage to act, but we must marshal our resources, defying the ambivalence and dismissiveness that make us more vulnerable to looming infectious disease threats. This is no time to retreat.

The post A Turning Point for Global Health appeared first on Medika Life.

To date, what we have been seeing in AI in healthcare is directed to managing data, data systems, and monetizing areas where potential is seen. This leaves us with one area that is of vital interest to all of us: we, the patients, need to understand how we are being considered. In other words, is healthcare and medicine, more directed toward management and giving less consideration to patients and their care in diagnosis and treatment?

As one physician recently told me, he is leaving medicine and doesn’t want anything to do with it in the future. In his words, he felt that private equity and AI were taking over healthcare, but not in a good way. “When I entered medicine,” he said, “we had all the patients’ information on one index card.”

At that point, he had a somewhat defeated look on his face, and he didn’t say anything more. Several months ago, another physician told me she felt what was being practiced now was “factory medicine.” What did she mean by that? She gave me several indications of how there was less care in selecting physicians for particular slots in practices, and she felt that too many were not adequately experienced or trained for what they were being asked to perform. All that was needed was an MD or DO, and they were hired for available slots.

These were only two examples, but I have others, too. Discouraged, another physician will leave the profession in two to three years. In fact, he could work at least two to three more decades in his specialty. However, a large hospital is pressuring him to sell or lose referrals. He is not selling and would rather close his practice. The loss here is obviously to the current patient base, who will have to seek care elsewhere.

The relationship and the experience that has been gained on both sides will also have been lost. I have also had to come to terms with how medicine is currently rotating physicians around to various offices, much to some of their dismay. As a result, I now have three new physicians with whom I have no prior contact. Do I need three? I doubt it.

What Does the Future Hold?

The further improvement of remote patient monitoring (RPM) will be one story of 2025. The pandemic hastened the adoption of RPM technologies, which are now fundamental to the treatment of chronic diseases, the recovery from surgery, and promoting healthy lifestyles.

There will be far-reaching effects on healthcare delivery as these technologies advance. This new technology allows physicians to track their patients’ vitals in real time, gather helpful information about their health, and act faster in the event of an emergency. Not only may this lead to better health outcomes for patients, but it could also help ease strain on already-strapped healthcare systems by preventing unnecessary visits to hospitals and emergency rooms.

But what of the lower-income patients who use hospital emergency rooms as their primary care site? If they can’t use RPM, what do they do? We know that the emergency room is a drain on finances, and charity care is even more of a drain. Hospitals are trying to decrease the patient load in those areas.

Does RPM truly represent an advance in medicine? Read carefully, and you will notice that physicians are becoming monitors rather than face-to-face providers. We are removing the human aspect and replacing it with technology.

Anyone who has ever studied psychology knows that human interaction plays a significant role in health and health maintenance. A digital device, whether implanted or worn on your wrist or hand, cannot replace this interaction, and we would have to question how sterile these environments will become. In fact, will they put physicians out of work?

Also, we need to question the infallibility of AI in terms of diagnostic competence and reasoning, as well as program bias. Because it’s computer-driven, it does not mean it is without fault, and therein lies a serious issue. No.

We’ve seen enough professional articles to know that not all technology is what it is advertised to be, such as robotic surgery or other forms of intervention. But patients can be blown away when they hear that instead of a real surgeon, they will have an automated piece of technology. Does that mean it’s better? No, unfortunately, it does not, but it may mean it’s more expensive. Once you buy equipment, you have to use it.

Even the Cleveland Clinic has indicated that proper standards and oversight are needed for all AI or it is inevitable that harm may result from it. But the advances, especially in specific radiology and breast cancer specialties, are impressive, and this hospital recognizes how it can contribute to healthcare.

One area where we may show some improvement is in note-taking. Some hospitals have a note-taker accompanying a physician on a patient’s visit. But there’s a new fillip in AI that addresses this.

Ambient listening, which uses machine learning to enhance audio, is a voice-recognition system that listens to and analyzes discussions between patients and providers in real-time, extracting pertinent information to be used in clinical notes and to meet billing and coding standards.

Organizations have examined and discovered obvious return on investment (ROI) around ambient listening solutions in terms of clinical efficiency and reducing burnout, which is why they are picking this as their first AI step. Does it address personnel burnout? This is a question that is still being posed in research.

Massive databases, including pictures, text, and other data required to train models, are the backbone of many AI systems. Despite the careful curation, some datasets may occasionally include illegal or unethical material.

In order to make sure that AI systems do not respond to users with damaging information, researchers implemented a mechanism called reinforcement learning from human feedback. To make AI systems more helpful and trustworthy, researchers use carefully selected databases of human preferences.

But if a researcher is unaware or insensitive to bias, can they truly curate AI? It has long been a concern that once a program is written and it absorbs scripts from previous programs, there is no way of knowing how bias may have entered the final product, but it’s there. How do you fix that? Again, that’s for future researchers.

Summoning up the major areas for AI, we see they include electronic health records, patient communication (EPIC is used by over 80 health systems to draft responses to questions), insurance and billing, scheduling and resource management, data, extraction, and analysis, and the assumed reducing burnout of staff.

What can AI do? What are the benefits to patients in terms of quality, efficiency, and accessibility of healthcare? Some of the key benefits include:

1. Improved diagnosis and treatment by analyzing medical data quickly with AI algorithms to detect patterns in medical imaging, x-rays, and MRIs.
2. Personalized medicine where treatment plans can be tailored to individual. Patient needs in terms of genetic information, lifestyle, and other health data. This should address decreasing side effects.
3. Predictive analytics where potential health issues are discovered through the analysis of trends and patterns found in patient data. This would then permit early intervention and preventive care, thereby improving outcomes.
4. Enhanced patient monitoring through AI-powered wearable devices and remote monitoring tools that continuously track a patient’s vital signs and other health metrics. These interventions are particularly helpful in cases of chronic conditions.
5. Streamlined administrative processes, such as appointment scheduling, billing, and record management, which reduce wait times and can improve patient experience.
6. Virtual health assistance in AI Chatbot provides instant access to medical information, answers to health-related questions, and guidance on managing conditions with self-care.
7. Mental health support through apps that provide cognitive, behavioral therapeutic interventions, mood tracking and stress management techniques. This would then make mental health care more accessible and immediate.
8. Drug discovery and development through AI greatly accelerates this process, leading to innovative treatments and medications more quickly.

Risks for AI in Healthcare

While the benefits of AI in healthcare are impressive and can be utilized in a range of areas, there is no such thing as a free lunch and we must always consider the risks that are attached to this type of healthcare management. What are we concerned about? Here are some of the things:

1. Bias and inequity where the system can perpetuate or even exacerbate biases in healthcare there why bringing about unequal treatment and outcomes for a different patient groups, specifically minorities and underserved populations.
2. Accuracy and reliability is of great concern because any system can make errors such as misdiagnosis or incorrect treatment recommendations. This area is especially crucial and must be carefully managed and monitored.
3. Data privacy and security must address and prevent breaches and misuse of data.
4. Transparency and explainability would be areas in which those who are not highly conversant with algorithms would experience difficulty understanding how conclusions were derived from the data.
5. Regulatory and legal challenges must be carefully addressed in new guidelines that address AI-specific issues.
6. Over-reliance on AI presents a risk leading to automation bias, where clinicians cannot see errors made by AI and assume it is infallible.
7. Integration with existing systems is especially important for any issue because not all algorithms can speak to other algorithms and require what is known as an API, which allows it to integrate one system into another, whereby they work well together.
8. Ethical concerns would be in informed consent, patient autonomy, and the potential for AI to replace human jobs.
9. Economic and accessibility issues revolve around the development and implementation of AI into healthcare solutions for smaller or resource-limited healthcare providers.

The age of automation and artificial intelligence is here to stay, and as more creative approaches are designed, using less energy and providing faster, more accurate results, we will see it spreading everywhere. As long as you have any type of computerized equipment, you will have access to AI-assisted learning and data analysis.

In fact, an algorithm can use your data to learn as it is trained, so that each of us can be a research subject without our knowledge. This may sound dystopian, but it does have major advantages because garnering large groups of people for research can be an extremely difficult, time-consuming, and expensive process. Each step we take that shortens any of these areas in terms of time or money means better health for all of us.

AI may not be the wonderful solution we seek currently, but it has extraordinary potential in the future as long as we balance its merits and potential challenges well.

The post Ogre in Disguise or Angel We Need in Healthcare? appeared first on Medika Life.

Ignoring food’s role in health denies its benefits and risks related to the lack of it. The current expression is not just implying that food is a pharmaceutical (which it would appear to be) but that prescribing food is a medical necessity.

The long-term effects of COVID-19 are adding to the yearly death toll from diet-related chronic diseases in the US, which already stands at about one million. In the United States, malnutrition and chronic diseases such as type 2 diabetes, cardiovascular disease (CVD), obesity, and certain malignancies are closely linked to poor dietary habits, making them the primary cause of death.

Among individuals in the United States, about 40% have pre-diabetes, and 11.3% have diabetes; most of these instances are type 2 diabetes. Around 37% of the U.S. population, or 126.9 million people aged 20 and more, will be living with cardiovascular disease in 2022. In 2021, there were 695,000 fatalities in the United States because of CVD, making it the top cause of death for both men and women.

Food Pharmacies

The food pharmacy is one new program model that aims to improve people’s diets by expanding their access to and consumption of healthy foods, especially produce. According to the available studies on the food pharmacy model’s effectiveness, these programs have helped patients better understand nutrition and overcome obstacles to healthy eating. As a result, they may have a major influence on health outcomes connected to diet.

Nevertheless, there has been a dearth of thorough research techniques and limited efforts to assess these programs’ efficacy. To properly evaluate the long-term impacts of food pharmacy programs on healthy eating and diet-related health outcomes, additional study is required. But the current evidence provides more than food for thought on the topic. How is this concept implemented?

Therapeutic meals are meals specifically designed to meet medical needs, and the food as medicine initiative also includes prescriptions for healthy food, produce, and other foods. They are usually supported by healthcare, the government, or charitable organizations, administered by clinicians through the healthcare system, and patients pay nothing or very little for them. But these programs are limited to specific areas of the world.

Researchers identified 32 papers in the literature examining food as medicine interventions using a PubMed database search and by polling a network of international colleagues. Several instances were located in other Western countries, although the majority were in the US. Other countries that contributed were Canada, the UK, and Australia. Brazil, Mexico, Germany, Ireland, and Finland did not have any. Philanthropic funding, rather than institutional or organizational backing, was crucial for the majority of activities. Statistics on the health effects of food-as-medicine programs were inconsistently available in the scholarly literature, reflecting these endeavors’ relative newness.

How Do They Work?

Located in Boston Medical Center! Founded in 2001, the Food Pantry dedicates itself to assisting low-income patients in overcoming nutrition-related illnesses and undernourishment. The Food Pantry serves as a bridge between patients and healthcare providers such as dietitians and doctors. Doctors at BMC clinics provide food prescriptions to improve patient health. Patients having cancer, HIV/AIDS, high blood pressure, diabetes, obesity, cardiovascular disease, and other long-term illnesses frequently visit the Pantry.

When it comes to nutrition, the goal of the food pharmacies at Children’s Hospital of Philadelphia is to help families struggling to put food on the table. They strive to ensure that families have access to the food and financial resources they require by providing direct grocery delivery to their homes and offering one-on-one resource navigation. Grocery delivery, financial consulting, and free fruit markets are a few of the programs provided because of partnerships with local businesses and organizations. Families who sign up for the Food Pharmacy program get free groceries for six months.

Another program that integrates medicine and food is at Tufts University. The Food Is Medicine launched this university-wide initiative at Tufts University’s Friedman School of Nutrition Science and Policy. Its goal is to improve health care by implementing scalable food-based interventions. Interventions include nutritional meals, doctor education, and improved clinical care for diet-related illnesses.

The University of Utah Health’s response to food insecurity is the Food Pharmacy program. This initiative is a component of the larger Driving Out Diabetes effort. In late summer of 2020, the program was initially offered. Its goal is to help those in the community who are food insecure and dealing with long-term health issues related to nutrition.

The food pharmacy is a trailer that can be moved and has all the necessary equipment for food service. Patients with a meal prescription from their clinician have access to a large selection of nutritious food options held by the pharmacy.

Eligible individuals with valid referrals or prescriptions can pick up meals from the trailer at two sites during business hours.

The value of nutritious foods and meals cannot be overstated as we see the relationship between nutrition and disorders of physical and mental health. In addition to providing healthful foods, these programs also encourage people to educate themselves regarding what they should eat; in addition, the programs, in the long run, can save government money on treating illnesses resulting from poor nutrition. One of the prime examples of these illnesses is obesity worldwide, which is of prime importance in health and medicine.

The post Food Is the Prescription, and Food Pharmacies Could Be the Way to Better Health appeared first on Medika Life.

Authorities finally brought the physician in question, Larry Nasser, to justice and sentenced him for multiple felony offenses against patients all over the state. This resulted in him receiving a sentence that could exceed 100 years in prison.

How could this have happened in a world where patients are supposed to trust their physicians, particularly their gynecologists? This medical specialty, as well as urology, gives the physician unfettered access to patients. Urology is where male sexual abuse occurs. How many men come forward with allegations of rape or sexual abuse by a physician?

The prestigious Columbia University paid out millions to abused patients and, curiously, the physician in question (Robert Hadden) had a prior charge of sexual abuse that was lowered and, according to The New York Times, the prosecutor “agreed to not seek prison time and promised not to pursue new sexual abuse allegations against him. His sex-offender status was reduced so that it would end after 20 years and his name would not be on an online list of offenders.” But his case is not the only one where a sexual abuser is permitted to remain free and practice medicine.

I was prompted to write this article today after seeing a media article about a female gynecologist who had been catfishing other women on an Internet dating platform where she presented herself as a man. The physician is still working at a reputable medical center, where management has decided the issue is irrelevant since she stopped doing it and was only engaged in that activity about a decade ago. A sociologist later discovered the charade and transformed it into a bestseller.

The Actions of Medical Boards

Medical boards are expected not only to uphold the standards of care but also to provide a layer of protection for both patients and practitioners. However, too often this is not the case, and I have been told by several physicians that certain state medical boards are less than vigorous in these regards. Patients soon learn that they will be given short shrift when expressing concerns about a physician’s behavior toward them.

Even though there is an explicit ban on doctors having sexual interactions with their patients, some physicians nevertheless abuse their patients sexually. No one knows how many doctors in the United States have sexually abused their patients. Only a small percentage of doctors have had “reportable” repercussions due to their unethical practices, according to data from the National Practitioner Data Bank on unfavorable disciplinary actions by state medical boards, institutional sanctions for peer review, and malpractice payouts.

A lack of clarification of licensure, prior employment, and potential actions brought to bear against physicians by institutions, such as hospitals and medical centers, is required. However, that may not be the case in every instance. Such a failure to adequately assess someone’s prior employment, obviously led to the infamous Dr. Michael Swango going from state to state where he killed patients. One dean became suspicious and started calling other facilities, which led to the complete uncovering of his activities and his apprehension. He may have killed 60 patients.

The issue is of particular personal concern to me since a relative, after a period of almost 40 years, told us that she had been sexually assaulted by our family physician when she was 16. She was afraid to tell anyone, at that time, because she thought she would not be believed. Ironically, this was the same man who delivered one of my sisters’ children, and we had implicit faith in him. Of course, that would have added to this relative’s reluctance to reveal anything.

Subsequently, the physician met with a horrific end. Men broke into his medical office, seeking drugs, and beat him so that he lost his vision, and a few years later, he died. We know from research, specifically on pedophiles, that persons with strong ties to families are the ones who are most likely to offend against that family.

For treatment of a spider bite behind her knee, a woman visited a family friend, Dr. Esmail Nadjmabadi. Under the guise of a colon cancer test, he sexually assaulted her in his exam room.

According to the Los Angeles Times, Nadjmabadi is included in a group of ten California doctors who regained their licenses after being suspended for sexual misconduct.

An analysis of board data conducted by the Times revealed that out of all doctors whose licenses were revoked for any other reason, the state Medical Board reinstated the licenses of almost 50% of sex offenders who applied for them.

How many investigators do medical boards employ, or do they employ any at all? We have a duty to protect healthcare professionals and patients from harm, including sexual harm. In the case of college-based medical care, we also see instances of sexual abuse by these professionals, and the schools are usually reluctant to have student victims take the case off campus to the local police.

University Clinics’ Involvement

In my wish to be fully informed, I once asked, a man who was responsible for student campus safety what he did when a woman student complained of unwanted sexual behavior by other students. “We move the man to another housing unit on campus,” he said, believing that solved the issue altogether. The police were never involved.

The case of Tatiana Tarasoff highlights the reluctance to involve law enforcement on campus. A student in therapy with a university-employed psychologist related his homicidal fantasies regarding Ms. Tarasoff. The psychologist and his mentor decided that only the campus police needed to know and the matter was not addressed with local authorities. Subsequently, upon returning to campus from a brief vacation, the woman was murdered, and the student pleaded mental impairment and left the country.

At one time, I had the opportunity to teach during the summer at a major university, and staff brought the issue of on-campus rape to my attention. I do not know if the parents who were bringing their daughters for campus tours were ever told about this, but it would seem they should have been informed.

The only notice that there was a problem was a flyer posted in some buildings stating that young women could request escorts back to their dormitories in the evening. While there, I recall that a young woman riding a bike on campus went missing.

I have to wonder if there were any complaints of untoward sexual behavior in the medical clinic on the grounds. Of course, I have nothing to base this on. I am merely asking the question.

Mental Health Professionals Abuse, Too

Medical professionals not only engage in sexual abuse of patients in physical exam situations but also mental health situations. A peer once told me about a psychiatrist who required women to strip to the waist for breast examinations during family therapy evaluations.

Anyone who knows anything about mental health knows that the mammaries are not involved in these kinds of evaluations. The resolution? After this staff found out about his actions, management permitted him to take a vacation and transfer to a clinic in another state where he probably practices. Did anyone check up on his prior employment?

A distressed student once told me that her boyfriend confided in her that his female psychologist was having sexual intercourse with him at every session. This act was unethical, and someone should have brought charges against her. His mother, a psychologist, referred him to this woman, obviously not knowing of her disregard for patients in service of her own pleasures.

In another instance, I learned years ago about a psychologist who was taking young male patients home from a psychiatric hospital for the weekend. Allegedly, this was a treat for their good behavior during the week, but his wife did not see it that way. The chief of psychology at the hospital dismissed her as a deranged woman with mental health problems when she complained. The woman had no history of mental health issues.

As far as I know, nobody investigated this alleged activity, and the chief sided with the psychologist against these allegations. Eventually, the psychologist left the hospital, and I found out he was having an affair with a priest. He and his wife did divorce.

How Can Patients Be Protected?

By implementing simple guidelines, the institutions we trust with our lives and health may not put an end to the trend of allowing patients to be sexually abused, but it can somewhat stifle criminal acts. Specifically, healthcare offices and systems should require one or two healthcare providers in the room during sensitive assessments.

All medical personnel must be obliged to complete extensive training programs regarding proper boundaries and patient rights before engaging in delicate examinations. They must also educate patients about proper boundaries and procedures before conducting sensitive exams.

All employment applications need to receive adequate verification and letters of recommendation from reliable sources. A person’s high profile cannot be viewed as a reason to dismiss this careful review.

Institutions that receive reports of abuse must act quickly to stop the abuse and investigate to determine exactly what happened. Creating strong reporting and discipline procedures might also motivate coworkers to report any wrongdoing. Patients should also report allegations of sexual abuse by medical personnel to the police.

Situations of a one up, one down, as in the case of medical care, are highly attractive for individuals with nefarious intentions. They must be thwarted and routed out before they can do any more damage to patients. Each of us should care for our “neighbors.” If we care for each other, then we provide the necessary protection against those who would care less.

The post Patient’s Medical Trust Shredded by Those Who Took the Oath appeared first on Medika Life.

It is inevitable that some people will die who get admitted to the ICU. It is always sad, and it makes us sad as critical care clinicians. It is reality, nonetheless. During the pandemic, it seemed that everyone who was admitted with COVID-19 ended up dying, and thank God, that was not the case at all.

Still, when it is clear that I will not win the battle against critical illness; when it is clear that my patient will die, then my fight changes to ensure that my patient does not die an ignoble death.

What is an ignoble death? It is one without dignity; it is a death not on the patient’s own terms; it is death of pain, distress, anguish, and suffering. No one deserves this kind of death.

None of us knows when we are going to die. None of us knows where we are going to die. None of us knows how we are going to die. Those things are, in fact, unknowable and beyond our control.

What we can control, however, are the terms of our own death. When we finally face death, how will we die? Will we die on machines? Will we die having the healthcare team pounding on our chests and shocking our hearts? Will we die having someone put a tube down my throat? Will my family be there?

We can choose the answers to those questions. We must choose the answers to those questions and make those answers known to our doctors and those taking care of us in the healthcare setting. It is absolutely essential – and dare I say it – critical that we make the answers to these questions known. Everyone deserves a death on their own terms.

And so, as a critical care specialist, I try my hardest to learn what the terms of my patients’ death are, and I fight my hardest – I battle to the fullest – to make sure that my patients die on their own terms. I battle to the fullest to make sure that my patients have a good death, one that is not ignoble: a death without pain, without suffering, without anguish, and on my patients’ terms.

During the COVID pandemic, it seemed that all we did for those afflicted with COVID was not curing the illness, but simply providing a good death. It did cause us a lot of anguish, because we are in the business of cure and healing. At the same time, there is nothing ignoble about providing a good death. If that’s all we can do for our patient, we have done our patient a tremendous amount of good.

Listen to the podcast episode about this topic here: https://healthcaremusings.substack.com/p/the-battle-against-an-ignoble-death

The post The Battle Against An Ignoble Death appeared first on Medika Life.

People with prosopometamorphosia have a rare eye distortion that changes how they see faces. Its exact cause is unknown, but it is generally linked to neurological disorders like migraines, epilepsy, and abnormal findings on CT scans and MRIs of the head. It has also been associated with Epstein-Barr virus.

The British neurologist Macdonald Critchley coined the word prosopometamorphopsia to describe a type of metamorphopsia in which people see people’s faces or parts of faces distortedly. On CT studies and MRIs of the head, metamorphoses are often linked to diseases of the eyes or brain.

The disorder should not be confused with another facial recognition issue, prosopagnosia, also known as face blindness. In this more common disorder, people are affected in different ways. Some people might not tell the difference between strangers and people they do not know very well. Some people might not recognize their own faces or the faces of their family and friends. The actor, Brad Pitt, has admitted he has the disorder and frequently cannot recognize people he knows.

Different people have different symptoms that can change the size, shape, color, and placement of facial features. The problem can last days, weeks, or even years, another thing that can change about PMO.

A new study of one person gave us new information about this case of the problem. Faces do not look twisted to the 58-year-old man with PMO when they are seen on a screen or on paper, but they look “demonic” when he sees them in person. Why would it only happen when he’s with the person? It almost sounds like there’s an element of emotion involved. But his wasn’t the only case described in the professional literature because one woman with the disorder had an unusual variant of it.

In yet another description of a patient with the disorder, a right-handed 67-year-old woman with a history of coronary artery disease, high cholesterol, high blood pressure, and diabetes mellitus described how she could see people’s faces tilted to the left. It seemed like the left eye on people’s faces was moving to the side and up when she saw them in person or watched TV pictures of people.

Looking at her own face in the mirror or at pictures of faces did not cause her to see any distortion. It was no problem for her to recognize faces, and only faces seemed twisted to her. Her neurological test came back normal. Additionally, her eye test did not reveal any significant findings. After two months of showing symptoms, a brain MRI revealed a brain obstruction or subacute infarct.

People with Alice in Wonderland syndrome (AIWS) can have one of forty types of metamorphopsia. Any part of the face-processing network can be involved, from the occipital to the frontal lobe. The link between the brain’s two hemispheres plays a key role, which suggests it may be because of interhemispheric transfer. There are many reasons for this, such as a stroke, seizure, or migraine. It can change how the whole face is seen. But, curiously, up to 30% of teens have short episodes of AIWS symptoms, according to research. However, the disorder is elusive because of the lack of documentation.

What Are the Diagnostic Criteria for AIWS?

There is also disagreement among experts about the exact symptoms and criteria for the disorder. Currently, there are no agreed-upon criteria for AIWS, so physicians usually use their professional opinion to decide whether someone has it. Because of the lack of consensus, experts think that this condition is often not identified or is diagnosed wrong.

Exploring possible causation besides brain dysfunction, strange perceptual changes can happen in several other ways. It is possible for AIWS to be a sign of a mental illness or a side effect of many medications. We’ve seen this in elderly patients with dementia who are taking certain medications for allergies. Then there are medications like those found in cough medicines, montelukast, which is used to treat asthma, and topiramate, which is used to treat seizures. Brain tumors can also cause it.

Could the disorder be caused by a mental illness such as schizophrenia? Delusions and hallucinations are important signs of schizophrenia. However, visual hallucinations and illusions are less likely to be the first signs and are usually associated with substance abuse. Although psychiatrists are taught to ask about hallucinations, most of the time, visual illusions and hallucinations are signs of health problems because auditory hallucinations are more common. But the symptoms vary so much that this adds to the difficulty of diagnosis.

Currently, the professional literature lists 42 visible symptoms and 16 somesthetic and other nonvisual symptoms. These signs differ from hallucinations or illusions. Treatments vary according to how the symptoms are viewed and have been treated with various methods, including ECT.

Researchers now know that, while AIWS is rare, it may be under-reported because of the lack of diagnostic criteria. However, it appears to be a short-lived perceptual change in many cases.

Anyone experiencing any of these symptoms is advised to consult with a medical professional for evaluation rather than think it will simply go away by itself. Significant, treatable disorders could require medical attention.

The post The Disorder That Makes Monster Faces Out of Everyone You See appeared first on Medika Life.

I’ve had a physician tell me, in strictest confidence, that the hospital replaces physicians who leave with any available MD, regardless of their expertise. “They see an MD as an MD, and that’s it.” We have to wonder what effect this has on patient care.

In an ideal practice setting, medicine and surgery are used in a two-way connection between a doctor and a patient, with support from leadership, staff, and the care team. The clinician has all the tools they need to heal. The goal should be to do what is best for the patient at all times.

But there is ample proof that the health system is becoming increasingly corporate. In 2023, 65 hospitals or health systems revealed deals to merge or buy other hospitals, bringing in more than $38 billion. The business of medicine is a big part of the economy, especially since the US spends almost $5 trillion a year on healthcare. And the system is underperforming.

Private equity investors have a big stake in the US healthcare system; they own more than 30% of hospitals in some markets and almost 400 hospitals. Little is left for the smaller hospitals or, indeed, the single practitioner who wishes to work independently. Little by little, they are being forced into a market that seems to smack of monopolistic practices.

In America’s profit-driven healthcare system, physicians believe they are hurt when managers, hospital executives, and insurers make them break the rules of ethics that were supposed to guide their profession. It is hard for many physicians to balance their Hippocratic oath with the reality of making money off of sick and vulnerable people. Some say this promotes a very high rate of physician suicide and burnout.

The 2024 physician burnout and depression study from Medscape says that almost half of physicians feel burned out. The number of physicians who are burned out has gone down since last year, when 53% said they were burned out. But many are considering leaving the field. Due to employees quitting, the resource gap in available care will widen. Nurses, too, are leaving the field because of overload, lack of support, and wages.

A physician I spoke to told me that he resisted being bought by a hospital chain and, as a result, will not be permitted to admit patients there or receive referrals; they are squeezing him out of existence. He now plans to leave medicine in about two years. The daily stress of dealing with insurance companies is exhausting for his staff.

The concerns regarding patient care are real, and the US government realizes them. The Office of Civil Rights in the U.S. Department of Health and Human Services released a rule about the nondiscrimination section in Section 1557 of the Affordable Care Act (PDF). This rule could punish doctors if they use algorithm-based tools that cause discriminatory harm.

The Federation of State Medical Boards also put out a set of rules saying that doctors are responsible for harm caused by tools that use algorithms. But what if the physicians or staff have little say over how algorithms are used and who uses them? Can we hold them responsible for management’s actions? And, if management is a private equity company, where does the buck stop? Harry Truman knew.

A new report from the World Health Organization (WHO) discusses five fundamental ways AI LLMs could be used in medicine and public health: diagnosis, patient care, administrative chores, medical education, and research. However, the study also warns that AI comes with big risks of bias, unfairness, privacy breaches, and problems with openness.

Experts and civil society groups share these worries. Depending on algorithms that are devoid of emotion and only deal with data is taking a road too far and giving too much power to a math formula over medical staff and patient input. In fact, there is NO patient input, only data.

One patient I knew who found a major error in the EHR attempted to have it remediated to the correct information—it took seven years, and the patient was told the hospital could do nothing about the EPIC software errors. How is it possible that a program has no fail-safe corrections for inaccurate diagnoses, treatments, or medications and on which major health decisions are made?

One thing about making professional decisions is that the situation is often much tougher and more complicated than people think. The assumption is that it is not hard to make a medically complicated decision. You need to gather a few facts and think about them like a medical professional (i.e., a doctor), and you can figure out exactly what the patient is sick with and how to treat it. That’s how AI would act, and it would be done within minutes if not seconds.

But medical staff need to consider more variables than the AI may have been trained on and therein may lie a bed of thorns. Who is truly conversant with the limits of AI training and the bias inherent within its vast network? Certainly, hospital staff aren’t equipped to do much. What are the potential harmful effects?

The AI tools and machine learning (ML) methods that make them up are not perfect, and it is not likely that they will ever be. So, adding AI will bring benefits and the common problem of AI tools making mistakes. According to a study from the European Parliamentary Research Service, one of the biggest risks of putting AI into healthcare is that it could hurt patients through mistakes.

Are hospital administrators or private equity managers up to the task of monitoring instead of zeroing in on the bottom-line savings of AI? Instead of becoming a major moneymaker for them, it could become a swamp of lawsuits that will push some of them into bankruptcy from major decisions against them.

Caution seems to have been thrown to the wind in the heady giddiness that may be exhibited by people who should know better. Yes, I realize I am being caustic, but people’s lives, livelihoods, and professions are on the line. We are not talking about trading stocks but working with lives.

The post Hospital Managers, Medical Decisions, and Patients’ Need to Know appeared first on Medika Life.