On Becoming a Healer
Episodes
Why it's time to remove time limits on tests, like USMLE exam
21 Apr 2026
Contributed by Lukas
There is a widely held misperception that being able to complete a test quickly is an indication of mastery when compared with those who need more tim...
Why Good Primary Care Is Non-Negotiable
17 Mar 2026
Contributed by Lukas
In a recent five-part series in the New England Journal of Medicine on the future of primary care, the author asks: "Has the long-term general doctor...
Preventing Suicide: How can we do better?
17 Feb 2026
Contributed by Lukas
Forty-five percent of patients who die by suicide saw a primary care physician in the prior month. Physicians screen for suicide risk just half the t...
Bad Leadership in Academic Medicine and Health Care: Let's Talk about It
20 Jan 2026
Contributed by Lukas
Unfortunately, bad leadership is common, with 50% of American's leaving a job because of a bad boss, and medicine is no exception. Saul and Stefan...
Poems about the wretched illness experience when your doctor is"clinically detached"
16 Dec 2025
Contributed by Lukas
Writing about the illness experience, medical sociologist Richard Frank described an unspoken agreement with his doctor that if he adopted their detac...
Assisted Dying: An End-of-Life Care Option or a Line Physicians Should Never Cross?
18 Nov 2025
Contributed by Lukas
A growing number of US states and other nations are legalizing either voluntary euthanasia in which a physician (or designate) administers lethal drug...
Why are we addicted to talking about opioids rather than helping people with chronic pain?
21 Oct 2025
Contributed by Lukas
For years, doctors and those learning to practice medicine were told pain is "the fifth vital sign" and to treat it aggressively – including with op...
Despite It All: stories from women who found joy in medicine despite joining a less than welcoming profession
16 Sep 2025
Contributed by Lukas
From the 1940 to the 1970's, medicine went from an almost exclusively male club to a profession in which women physicians were commonplace. Our phys...
The biopsychosocial model: What would it take to really replace the biomedical model?
19 Aug 2025
Contributed by Lukas
Medical educators generally acknowledge the importance of training doctors who care for the whole patient rather than just treat the disease. Most me...
"Disability is part of the human experience": So why not treat it that way?
15 Jul 2025
Contributed by Lukas
Soon after Lisa Iezzoni MD was diagnosed with multiple sclerosis during her first year at Harvard Medical School, from which she graduated in 1984, fa...
The Extraordinary Dr. Richard Clarke Cabot
17 Jun 2025
Contributed by Lukas
It is difficult to overstate the achievements of Richard Clarke Cabot (1868-1939) a relatively little-known, old-moneyed physician of the early 20th c...
Emboldened Bullies Come for Medical Education
01 May 2025
Contributed by Lukas
In an April 23rd executive order (EO), the president of the United States alleges that the Liaison Committee for Medical Education (LCME) and the Acc...
Physicians and Authoritarians: Are We Too Obedient?
08 Apr 2025
Contributed by Lukas
The record of physicians standing up for their values as healers under authoritarian regimes is not good, whether it's Nazi Germany, the former Soviet...
Caring for Patients or Policing Them? Prescription Drug Monitoring, Doctors and Opioids
18 Mar 2025
Contributed by Lukas
Prescription Drug Monitoring Programs (PDMPs) were originally designed for law enforcement to monitor patients and physicians for criminal behavior be...
What can we learn from all those "Why I quit medicine" videos on YouTube?
18 Feb 2025
Contributed by Lukas
There are a lot of videos on YouTube that feature typically young physicians explaining why they decided to leave the profession after years of dedica...
The New Medical School Graduation Competencies and Why One of the Them Stands Out
21 Jan 2025
Contributed by Lukas
In December 2024, the three organizations that oversee medical school (MD and DO) and residency education released a set of "Foundational Competencies...
A Conversation with Pediatric Surgeon John Lawrence MD, Past Board President of Doctors Without Borders, USA
17 Dec 2024
Contributed by Lukas
At a moment of increasing isolationism and xenophobia and -- for physicians – burnout, in a highly bureaucratic and profit driven health system, ser...
Addressing Social Drivers of Health: What is the role of the clinician?
19 Nov 2024
Contributed by Lukas
In can be confusing and even demoralizing for a medical student or resident to understand what's expected of them when caring for patients with socia...
"Simonisms": Revisiting the uncommon wisdom of a physician and educator who shaped us deeply
15 Oct 2024
Contributed by Lukas
To commemorate the start of our fifth season, we revisit a conversation we had almost two years ago about the wisdom of Simon Auster, MD. Simon was a ...
Do the doctors who sold Matthew Perry ketamine indicate something rotten in mainstream medicine?
17 Sep 2024
Contributed by Lukas
The two doctors charged for their roles in the events leading up to actor Matthew Perry's death were both involved in a "side hustle": selling ketamin...
Some Pitfalls of Narrative Medicine and How to Avoid Them
20 Aug 2024
Contributed by Lukas
The term "Narrative Medicine" (NM) refers to a range of activities, including close reading and reflective writing about literature, designed to impro...
The chasm between how doctors are taught to communicate and what they actually sound like
23 Jul 2024
Contributed by Lukas
There is an idealized version of physician-patient communication that is taught in medical schools, reinforced with acronyms like PEARLS, SPIKES, and ...
What do we lose and what do we gain by calling addiction a disease?
18 Jun 2024
Contributed by Lukas
The National Institute on Drug Abuse defines addiction as a "chronic disease" occurring in the brain – Many believe this definition can help to redu...
Can we learn and practice medicine well in a system that is so ill?
21 May 2024
Contributed by Lukas
In his book, The Present Illness, American Health Care and Its Afflictions, physician and historian Martin Shapiro, MD, PhD, MPH presents a scathing c...
"Tough Love" is Not the Answer: A critique of NEJM reporting on student/trainee grievances and educator discontent
16 Apr 2024
Contributed by Lukas
A recent NEJM article and accompanying podcast episode ("Tough Love") authored and hosted by the Journal's national correspondent sound the alarm tha...
What a James Baldwin story can teach doctors and patients about care amidst suffering
19 Mar 2024
Contributed by Lukas
"Sonny's Blues" is a 1956 story by the author, James Baldwin, about a "sensible" and pragmatic algebra teacher and his younger musically gifted younge...
How confronting racist ideas I didn't realize I had is shaping me as a physician and a person
20 Feb 2024
Contributed by Lukas
In a 2021 episode that we reran last month, "About me being racist: a conversation that follows an apology," Saul talked with a former Black colleague...
About me being racist: A conversation that follows an apology
16 Jan 2024
Contributed by Lukas
We are re-running this episode from 2021 because we're releasing a sequel next month in which Saul reflects on his journey confronting racist ideas he...
How effects of racism were mistaken for "race" in clinical algorithms: What clinicians should know
19 Dec 2023
Contributed by Lukas
For years, when physicians order tests to assess lung function, or blood work to determine kidney function, or look up guidelines for managing high bl...
Drug testing at time of birth: How physicians are co-opted into harming families while thinking they are doing the right thing
21 Nov 2023
Contributed by Lukas
The practice of urine drug testing during pregnancy and then often reporting positive results to Child Protective Services triggers a cascade that can...
Directly and Covertly Observing Care: How it Can Transform Medical Education and Improve Clinical Practice
18 Oct 2023
Contributed by Lukas
Direct, covert observation of health care is a novel and underutilized tool to assess health care trainees and clinicians. In this episode we talk wit...
"Dire Consequences": When students do not receive appropriate accommodations on the USMLE examinations
19 Sep 2023
Contributed by Lukas
In the prior episode we learned that there is no evidence that time-limited testing improves test validity and that, in fact, there is ample research ...
Why it's time to remove time limits on tests, like the USMLE exams
22 Aug 2023
Contributed by Lukas
There is a widely held perception that being able to complete a test quickly is an indication of mastery when compared with those who need more time. ...
Running the Gauntlet: My Journey into Medicine with a Learning Disability
25 Jul 2023
Contributed by Lukas
Stefan interviews co-host Saul about his experiences becoming a doctor with a learning disability. This episode, first run in 2020, sets the stage f...
Why are doctors turning to ChatGPT for help relating to patients?
27 Jun 2023
Contributed by Lukas
A recent New York Times article, titled "When Doctors Use a Chatbot to Improve Their Bedside Manner," should raise questions about why physicians are ...
Prescription Opioid Reductions and Suicide: What Should Caring Physicians Do in the Face of Uncertainty?
23 May 2023
Contributed by Lukas
The narrative that getting patients with chronic pain off opioids makes them safer was reinforced by a recent paper that got substantial media attent...
My patient's in shackles: Can we take these off?
18 Apr 2023
Contributed by Lukas
We might assume that a patient who is chained to their hospital bed must be restrained for good reason, but our guest challenges that assumption in a ...
From medical student mistreatment to burnout: How can we change the culture?
22 Mar 2023
Contributed by Lukas
In this second of a two-episode series on medical student mistreatment, we discuss its impact on burnout with a colleague who is working to change the...
Medical Student Mistreatment: A Wicked Problem
21 Feb 2023
Contributed by Lukas
How is it that a healing profession -- medicine -- has such a deeply ingrained culture of harming its own? And what can we do about it? In this fi...
Uncommon wisdom from a family physician and medical educator
19 Jan 2023
Contributed by Lukas
Simon Auster, MD, was a family physician, psychiatrist, and medical educator who had extraordinary insight about practicing medicine but absolutely ze...
Challenging Questions to Help Physicians Reflect, Grow, and Find More Joy Practicing Medicine
15 Dec 2022
Contributed by Lukas
Medical training and practice habituates physicians to a culture that narrows the possibilities we see for finding joy and meaning in our work. We oft...
Organic Chemistry and the Questionable Ways We Select and Train Physicians
16 Nov 2022
Contributed by Lukas
In October, the New York Times published the first of several articles about an eminent professor at NYU who was dismissed after his students complain...
Contextualizing Care in a Nutshell (and a New Study)
24 Oct 2022
Contributed by Lukas
Today, Stefan talks with Saul about his favorite topic (and life's work), contextualizing care. We're re-releasing this conversation (from January of ...
Medical Gaslighting: Why Are We A--holes?
19 Sep 2022
Contributed by Lukas
Recent articles in mainstream media about "medical gaslighting" have struck a nerve with thousands of comments on social media platforms. People are c...
Urine Drug Screening: How it can traumatize patients and undermine the physician-patient relationship without helping anyone
11 Aug 2022
Contributed by Lukas
Urine drug screening (UDS) is used in the care of patients with opioid use disorder, and for patients receiving opioids for chronic pain. There's n...
Pursuing a Medical Career While Black: What it Takes and Why it Matters
14 Jul 2022
Contributed by Lukas
Making it into and through medical school is tough even for those who have all the advantages: excellent schools starting at a young age, well-educate...
Rescuing medical professionalism: Could "cup-of-coffee conversations" do more good than committees and letters-to-the-file?
26 May 2022
Contributed by Lukas
Medical students may be subject to professionalism review by committees, most commonly for "unreliability" such as not responding to emails, falling b...
Why Residents Unionize
21 Apr 2022
Contributed by Lukas
Many residents are not doing well, psychologically, and sometimes physically -- and with good reason. High levels of mistreatment and harassment, pati...
Opioids and the physician-patient relationship: What are we getting wrong?
15 Mar 2022
Contributed by Lukas
The opioid crisis was precipitated by physicians overprescribing opioid pain medication, egged on by the pharmaceutical industry, contributing to suff...
False Positives Traumatize Patients...If Clinicians Aren't Careful
19 Jan 2022
Contributed by Lukas
On January 1st, the New York Times ran a story about prenatal genetic tests that are "usually wrong" -- but they got it wrong. These are actually just...
Healing Interactions: What are they made of?
26 Dec 2021
Contributed by Lukas
There are two qualities we may experience in others who comfort and ground us when we feel vulnerable and lost. First that they engage with us, mean...
Kind People on Airplanes
24 Nov 2021
Contributed by Lukas
Lately we've been hearing about bad behavior on airplanes. Here we discuss an incident in which a passenger unselfconsiously stepped up at an inconven...
When an attending yells at a resident
28 Oct 2021
Contributed by Lukas
Our guest, a physician a few years out of residency, describes an experience from her training when an attending yelled at her and hung up the phone w...
When your patient has a Swastika tattoo
09 Sep 2021
Contributed by Lukas
Our guest, a resident physician, describes her reaction and what followed, when she discovered a symbol of hate tattooed on her hospitalized patient's...
About me being racist: A conversation that follows an apology
28 Jul 2021
Contributed by Lukas
Saul reached out to a former colleague whom he worked with closely so that he could apologize for something he did many years ago that he now sees as ...
The Dartmouth Debacle: Why the culture of medical education needs to change
21 Jun 2021
Contributed by Lukas
In a widely reported incident, Dartmouth Geisel School of Medicine accused, suspended and expelled medical students for cheating based on faulty data ...
Vaccine Hesitancy and the Doctor-Patient Relationship
17 May 2021
Contributed by Lukas
A primary care doctor in solo practice in a small mid-west city who is deeply trusted by his patients talks about talking about vaccine hesitancy.
Engagement and Boundary Clarity:
09 May 2021
Contributed by Lukas
We feel safe and can open up in conversations when there is full and open engagement combined with a clear, respectful sense of personal boundaries. ...
Judgementalism
22 Mar 2021
Contributed by Lukas
Physicians are neither judges nor God, and yet we seem prone to judge our patients...and ourselves. Saul and Stefan discuss.
Contextualizing Care: What it means and why it matters
19 Jan 2021
Contributed by Lukas
Saul and his research team have listened to and analyzed thousands of audio recordings of medical encounters for clinician attention to the life conte...
Part 2: International Medicine
03 Jan 2021
Contributed by Lukas
In Part 2 of our interview with Dr. Bhalla, hear what makes for a good fit for a long term career practicing medicine and leading projects in internat...
Part 1. International Medicine
03 Jan 2021
Contributed by Lukas
A physician describes what attracted her to international medicine where she's worked for Doctors Without Borders in many challenging places. Guest: N...
My Learning Disability
29 Nov 2020
Contributed by Lukas
Stefan interviews Saul about his experiences becoming a doctor with a learning disability, leading to questions such as: Does struggling with multiple...
Asking patients "Why?"
10 Nov 2020
Contributed by Lukas
What should a doctor do when a patient behaves in a way that doesn't seem to make sense? Saul and Stefan discuss a case.
Part 2: "This is what I trained for."
31 Oct 2020
Contributed by Lukas
In Part 2 of our interview with Dr. John Scala, hear how an experienced primary care physician in solo practice responds to the pandemic, particularly...
Part 1: Meaning and Joy in Solo Practice
31 Oct 2020
Contributed by Lukas
A primary care physician describes why he's loved being a solo doctor, mostly avoiding corporate medicine. His patients love him too. Learn how and ...
Part 2: Hope and Healing for Those Who Follow
19 Oct 2020
Contributed by Lukas
Dr. Conway responds to violence and hopelessness in her community, traumatized by systemic racism, by establishing the I Am Abel Foundation as a haven...
Part 1: Pursuing a Dream and a Calling
19 Oct 2020
Contributed by Lukas
Dr. LaMenta Conway shares what she experienced and learned growing up in an economically and socially marginalized community in Chicago, pursuing a dr...
Forced Opioid Taper
11 Sep 2020
Contributed by Lukas
A middle aged man had been on a high but stable dose of opioids for years for chronic pain. His provider decides to wean him. He says "I'm not sure ...
Airplane Guy
10 Sep 2020
Contributed by Lukas
What's a better way to pick a student for medical school: High MCAT scores or seeing them help a vulnerable stranger when it's inconvenient and they t...
Patient Abuse
10 Sep 2020
Contributed by Lukas
A very bright physician scares a patient from a marginalized community out of the ER with a nasty prank -- and "I laughed too." How does this happen...
The "Difficult" Patient
10 Sep 2020
Contributed by Lukas
A patient got labelled as "difficult" who really wasn't so difficult, and it cost him his life. Where did things go wrong? Details changed to assure...
Introducing: On Becoming a Healer
06 Sep 2020
Contributed by Lukas
Introducing a new podcast that takes a critical look at medical training and the culture of medicine. Explores how interpersonal boundary clarity and ...