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Ryan Yarnall, MD Ryan Yarnall, MD (1 Posts)

Resident Physician Contributing Writer

OU School of Community Medicine


Ryan is a second-year internal medicine resident at OU School of Community Medicine in Tulsa, Oklahoma. He had published a few articles for in-Training as a medical student and wishes to continue writing during the busy times of residency and beyond.




We’re Ignoring a Key Factor in the Opioid Epidemic

In order for the country to make meaningful progress in tackling the opioid epidemic, we need a cultural shift in the way patients and providers think about pain.

Pharmaceutical companies and physicians are being demonized for their manufacturing and dispensing of opioid analgesics. Money-hungry executives from Big Pharma caused the crisis by brainwashing doctors to prescribe these medications left and right. Greedy doctors want patients dependent upon them for years, ensuring a steady stream of paying patients in their waiting room. Drugs drive the market. Drugs lead to big profits for everyone involved. The more drugs, the better.

Figure 1. “Relationship between System 1 and System 2 thinking.” Daily encounters lead to the activation of System 1 or System 2 thinking. Problems demanding higher levels of thought either directly or indirectly activate System 2. Repetitive exposure decreases the demand for System 2 thinking and increases both productivity and the risk for error.

Systems-Based Thinking: How Subconscious Thought Affects Medical Decision Making

System-based thinking describes a set of subconscious thought processes aptly named System 1 and System 2. The profession of medicine relies heavily on SBT — the ability to rapidly diagnose, treat, and improvise during stressful situations is dependent on these systems, which develop and mature throughout one’s training.

A Modest Proposal: There is No Substitute for Time in Medicine

Physician burnout has emerged as an increasingly concerning phenomenon in medicine. As high as 51% of physicians in a Medscape survey report symptoms of burnout. Doctors face higher demands with less time and support. Academic medical centers, which historically have been insulated from outside forces, are now seeing larger patient censuses, leaving less time for physicians to work through each patient’s case carefully.

Gebran Khneizer, MD Gebran Khneizer, MD (1 Posts)

Resident Physician Contributing Writer

Saint Louis University Hospital


Gebran was born and raised in Beirut, Lebanon. He comes from a family of five children, including four sisters. After his volunteering experience at the Children Cancer Center of Lebanon, Gebran decided to pursue pre-medical studies at American University of Beirut. He also attended medical school there. Following that, he pursued postdoctoral research in transplant Nephrology at Johns Hopkins. He completed his residency in Internal Medicine at Saint Louis University hospital. For the love of the Midwest, he plans to move to Indiana University to work in academic hospital medicine. Basketball and scuba diving are some of Gebran's passions. In his free time, he enjoys watching the NBA and buying all the gear for the Cleveland Cavaliers.