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In this excerpt Dr. Joshua John‑Ram Schacter reflects on the escalating pressures in modern clinical practice. He notes a dual trend: physicians are experiencing ever‑increasing workloads while simultaneously receiving lower compensation. Concurrently, attention to patients' health needs is diminishing. When he attempted to launch quality‑improvement initiatives—such as routine hemoglobin A1C screening and smoking‑cessation counseling—hospital administrators pushed back, citing concerns that these measures would delay surgeries. This tension illustrates how administrative priorities can conflict with patient‑safety goals, contributing to physician burnout and perceived neglect of patient health. Dr. Schacter ends by inviting peers to share similar experiences, underscoring the widespread nature of these systemic challenges.

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