Unknown Unknowns

Picture a late morning scene at a watering hole in Etosha National Park in Namibia. The sun is getting close to its apex position in the sky, its fierce rays pierce through the cloudless sky onto the ground.  All types of animals from a family of majestic African elephants to a tower of leggy giraffes… Continue reading Unknown Unknowns

Quality Detector

“Data is the new gold” is the mantra of our age. The data scientist has been termed the “sexiest job of the 21st century.” Every industry is driven by the impetus to acquire, curate, and analyze all aspects of their business. We measure and quantify everything with the promise of utilizing this data to drive… Continue reading Quality Detector


Humans are natural pattern recognition machines. We have an evolved instinct not only to recognize different patterns but also to categorize and store these patterns in order to make future predictions. In fact, this ability to recognize and represent patterns to draw a variety of intuitive inferences could be the defining and most original characteristic… Continue reading Stereotypes

Fountain of Youth

Maximum lifespan is defined as the maximum number of time members of a species have been observed to live. According to the Hebrew Bible, Methuselah lived until the age of 969. More contemporaneously, Jeanne Calment, holds the distinction for the longest recorded human lifespan of 122 years. When she was born in 1875, the germ theory of… Continue reading Fountain of Youth

Mobility and Mortality (M&Ms)

Mobility is defined as the ability to move freely and easily. After the initial magical moments when we take our first steps and until we begin to lose this mobility under the insidious burden of chronic disease, this mobility is mostly taken for granted. However, it is the hallmark of our humanity, evolutionarily and developmentally.… Continue reading Mobility and Mortality (M&Ms)

Hunger games

Hara hachi bu is a Confucian adage that dates back 2500 years and instructs people to eat until they are 80% full. The Okinawans from Japan use this mantra before every meal, enabling them to be mindful of their food consumption. Elderly Okinawans have among the lowest mortality rates in the world from a multitude… Continue reading Hunger games


I recently read an interesting book titled, Overdiagnosed: Making People Sick in Pursuit of Health. In the book, Dr. Welch talks about the dangers of over-diagnosis and how it is “biggest problem posed by modern medicine.” Over-diagnosis is defined as the diagnoses that will never cause symptoms or death and generally occurs because doctors seek… Continue reading Over-Pharmaceuticalized

What’s the DALY

Aging is the defined as the gradual functional and structural decline of an organism, resulting in an increasing risk of disease, impairment, and mortality over the life span. It is thought to be reliant upon a balance of exposure and resiliency. By 2050, the world population aged 80 years and above will more than triple… Continue reading What’s the DALY

The State of the Emergency Department

Almost 1.5 years ago, I wrote a blog piece titled Compassion Fatigue, in which I spoke about the high rate of physician burn out especially amongst front line physicians such as Emergency Physicians and Primary Care doctors. Anecdotally, the problem seems to be only worsening especially amongst ER physicians. There is not a week that… Continue reading The State of the Emergency Department

Metabolic Ghetto

The staggering increase in the prevalence and incidence of metabolic syndrome and its various components is especially alarming amongst minority populations worldwide and within the United States. For example, the prevalence of Type 2 diabetes has doubled in India in the last 30 years, obesity rates have increased 3 fold or more since 1980 in… Continue reading Metabolic Ghetto

My Journey with Metabolic Syndrome

In January 2013, I had blood work drawn and to my shock and dismay I was diagnosed with metabolic syndrome. My fasting blood sugar was elevated and I had atherogenic dyslipidemia. In hindsight, the results of the lab should not have been a surprise as I not only had a strong family history of metabolic… Continue reading My Journey with Metabolic Syndrome

The Digital Divide

The idea of precision or personalized medicine is gaining a lot of attention. In his State of the Union speech, President Obama launched the Precision Medicine Initiative “that will help deliver the right treatment to the right patient at the right time.” Additionally, I recently came across a press release announcing the appointment of a… Continue reading The Digital Divide

Data rich but Information and Knowledge poor

The processing capacity of the conscious mind has been estimated at 120 bits per second. To put that in context, in order to understand one person talking to you, we need to process 60 bits of information per second. Primary care physicians on an average deal with three problems per patient and it is estimated… Continue reading Data rich but Information and Knowledge poor

How do we get patients engaged in their care?

According to a meta-analysis published in the Annals of Internal Medicine (2012), Americans are failing to comply with medication prescriptions and it's costing them anywhere between $100 billion to $289 billion a year. 20 to 30 percent of prescriptions are never filled and almost 50 percent of medications aren't taken as prescribed. (Annals of Internal Medicine,… Continue reading How do we get patients engaged in their care?

I eat, therefore I am

            Meta-analyses of health outcomes studies show that medical care affects long-term health outcomes by about 10%, genetics determine about 20%, and the other 70% is a combination of social determinants – environment and behavior. Despite these percentages, the focus of the health care industry and policy makers in the… Continue reading I eat, therefore I am