Physician voices

12,647 articles · Since 2006

Physicians writing on KevinMD about the life of the profession: the work itself, the exhaustion, what women physicians are paid and asked to carry, the losses the profession has been slow to name, and who decides how physicians work. Five maintained records draw on this archive: Physician burnout: what physicians say, in their own words, Primary care: what physicians say, in their own words, Women in medicine: what women physicians say, in their own words, Physician suicide: what physicians say, in their own words, and Physicians and administrators: what physicians say about who runs medicine, in their own words.

Latest articles

What David Satcher taught me about health disparities

Ronald L. Lindsay, MD

October 18, 2026Oct 18, 2026

In December 2001, I received an invitation that surprised me. U.S. Surgeon General David Satcher invited me to present at his final official conference, Closing the Gap: Surgeon General's National Conference on Health Disparities and Mental Retardation. The invitation was…

In December 2001, I received an invitation that surprised me. U.S. Surgeon General David Satcher invited me to present at his final official conference, Closing the Gap: Surgeon General’s National Conference on Health Disparities and Mental Retardation.

The invitation was unexpected. At the time, I was directing Ohio’s Rural Developmental and Behavioral Clinic Initiative, a program designed to bring developmental and behavioral services to underserved communities. The work aligned closely with …

Why physician depression goes untreated, and what helps

Ravi Singareddy, MD

October 18, 2026Oct 18, 2026

Few of us would tell a patient with moderate-to-severe depression to wait it out alone. Many of us do exactly that for ourselves. Physicians develop depression at rates comparable to or higher than the general population, yet we are among…

A 2025 JAMA strategic review found that fear of stigma was a primary barrier to seeking help for …

Your physician mindset is keeping you on the hamster wheel

Tracy Gapin, MD

October 18, 2026Oct 18, 2026

You've been trained to obey and execute. To be the operator, the one grinding, reacting, and doing the work others have designed for you. Medical school taught you to follow protocols. Residency taught you to work within systems. Your career…

You’ve been trained to obey and execute. To be the operator, the one grinding, reacting, and doing the work others have designed for you. Medical school taught you to follow protocols. Residency taught you to work within systems. Your career has reinforced the pattern of being the highly skilled technician who executes what others decide.

Someone else decides how much time you can spend with patients. Someone else determines what treatments …

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Why the annual physical shortchanges patients and doctors

Acey Albert, MD

October 17, 2026Oct 17, 2026

A patient called my office last month asking if she could "just get her labs done" without coming in. She wasn't being difficult. She'd had the same panel run every year for a decade, felt fine, and didn't see why…

A patient called my office last month asking if she could “just get her labs done” without coming in. She wasn’t being difficult. She’d had the same panel run every year for a decade, felt fine, and didn’t see why a 15-minute conversation needed to precede a blood draw. Another patient, a few weeks later, arrived for his physical with a list of eleven things he wanted addressed: three medication …

6 lessons from William Osler for emergency medicine

Dr. Rida Jawed

October 17, 2026Oct 17, 2026

Emergency medicine has changed dramatically since Sir William Osler practiced medicine. Our departments now run on rapid triage, bedside ultrasound, advanced imaging, resuscitation protocols, electronic records, and increasingly sophisticated decision tools. Yet some of the hardest parts of the job…

Yet some of the hardest parts of the job have changed very little. We still make decisions with incomplete information. We still care for frightened patients and families on some of the worst days of their lives. We still make …

An insurance denial kept my patient from end-of-life care

Sameen Farooq, MD

October 16, 2026Oct 16, 2026

My patient lay in the hospital bed approaching end of life. We had a plan to get the patient to an inpatient setting for active symptom management for end-of-life care. Everything was in place until we got a denial from the insurance for coverage for inpatient end-of-life care. The reason for denial was “lack of medical necessity.” The rage I have felt experiencing this situation over my decade-long experience as …

Diane W. Shannon, MD, MPH, on physician burnout and sustainable careers: a KevinMD subscriber spotlight

Subscriber Spotlight by KevinMD

October 16, 2026Oct 16, 2026

Diane W. Shannon, MD, MPH, is an internist who left clinical practice after burning out early in her primary care career and now coaches physicians, with a focus on women physicians and careers that last. She has published 48 essays…

…

Time for ACGME to drop maintenance of certification

National Board of Physicians and Surgeons

October 15, 2026Oct 15, 202630

The Accreditation Council for Graduate Medical Education (ACGME) is currently accepting comments regarding updates to its Common Program Requirements. A quick glance at its proposed strikeouts and additions might suggest a routine and bureaucratic exercise, far removed from the minds or priorities of busy practicing physicians. In reality, ACGME’s update presents an important and urgent opportunity for physicians to be a voice for change in academic medicine. Physicians have until …

The medical malpractice crisis began in Cook County

Howard Smith, MD

October 15, 2026Oct 15, 2026

The story of medical malpractice litigation in the United States is like the famous passage in Macbeth. "It is a tale told by an idiot, full of sound and fury, signifying nothing." Medical malpractice lawsuits are nothing new. They have…

The story of medical malpractice litigation in the United States is like the famous passage in Macbeth. “It is a tale told by an idiot, full of sound and fury, signifying nothing.”

Medical malpractice lawsuits are nothing new. They have been filed and tried in America’s courts since 1784. Between 1835 and 1865, there was a rash of them. One might even call it a crisis.

Medical liability insurance is, also, …

How a misread living will led to a 6-day court fight

Ferdinando Mirarchi, DO

October 15, 2026Oct 15, 2026

Six days. $20,000 in legal fees. One advance directive (living will) applied too soon. A 60-year-old man suffered complications after cardiac catheterization, developing acute kidney injury from the intra-arterial dye and pulmonary edema requiring intubation. Serious? Yes. Reversible? Yes. The…

Six days. $20,000 in legal fees. One advance directive (living will) applied too soon.

A 60-year-old man suffered complications after cardiac catheterization, developing acute kidney injury from the intra-arterial dye and pulmonary edema requiring intubation. Serious? Yes. Reversible? Yes.

The patient just needed short-term ventilatory support and temporary dialysis. The plan, consent, and scheduling of a temporary dialysis catheter ensued. Then his advance directive was found.

The attending physician concluded the patient should …

What Gold Star families need beyond flags and funerals

Ronald L. Lindsay, MD

October 15, 2026Oct 15, 2026

At 2 a.m. on Saturday, Oct. 3, 1970, someone started pounding on our apartment door. My mother thought it was a prank. She had ignored the buzzer downstairs because neighborhood kids occasionally rang doorbells in the middle of the night.…

Instead, he found two Air Force officers standing at the door. One was a lieutenant colonel. The other was a chaplain. …

The physician retention problem nobody wants to touch

Melissa Welker, MD, MPH

October 14, 2026Oct 14, 2026

I keenly remember the day one of our partners said he was quitting as soon as possible (no new job lined up, no plan). His dad had died just days before, and he said he simply didn't know how to…

I keenly remember the day one of our partners said he was quitting as soon as possible (no new job lined up, no plan). His dad had died just days before, and he said he simply didn’t know how to keep going. He needed a break, and this was his way out.

For those in private practice, this story likely hits a nerve. Life happens. Physicians hurt and struggle, and often …

AI diagnosis can list 100 causes but can’t examine you

Duane Penshorn, MD

October 13, 2026Oct 13, 2026

The triage note read, "The patient wants her thyroid checked." On the stretcher, fully dressed, sat a 65-year-old woman with her family members at the bedside. She said she had been feeling weak and tired lately, so bad that even…

The triage note read, “The patient wants her thyroid checked.”

On the stretcher, fully dressed, sat a 65-year-old woman with her family members at the bedside. She said she had been feeling weak and tired lately, so bad that even her voice had turned hoarse. She’d never had any problems with her thyroid in her life, but she had looked it up; maybe it was her thyroid or anemia. That was …

Prior authorization delays run on 3 clocks, not just 1

Comron Saifi, MD

October 13, 2026Oct 13, 2026

When a surgeon tells a patient, "You need surgery," the patient understandably hears that the next step is scheduling it. Inside the practice, however, an entirely different process is just beginning. The clinical decision must be converted into documentation. The…

When a surgeon tells a patient, “You need surgery,” the patient understandably hears that the next step is scheduling it. Inside the practice, however, an entirely different process is just beginning.

The clinical decision must be converted into documentation. The documentation must be translated into the language of a payer’s policy. The request must reach the organization that actually controls the decision. Only then does the formal review begin.

Prior authorization is …

Sleep deprivation in doctors is a culture problem

Ravi Singareddy, MD

October 13, 2026Oct 13, 2026

The clocks fall back on Sunday, Nov. 1, and most of us will tell our patients the same sensible things we always do: protect your sleep window, keep a consistent wake time, treat insomnia before it becomes chronic. Then we…

Medicine has a culture problem around rest. Somewhere in training we absorb the idea …

Who vets your medical malpractice expert witness?

Howard Smith, MD

October 13, 2026Oct 13, 2026

The famous passage in Macbeth, "a tale told by an idiot, full of sound and fury, signifying nothing," refers to the futility of life. Or does it refer to a medical malpractice lawsuit? There are 175 lawyers in Congress; 1…

The famous passage in Macbeth, “a tale told by an idiot, full of sound and fury, signifying nothing,” refers to the futility of life. Or does it refer to a medical malpractice lawsuit?

There are 175 lawyers in Congress; 1 out of every 3 members is a lawyer. There are, also, 20 doctors; 1 out of every 27 members is a doctor.

Of the 175 lawyers, those who were formerly malpractice attorneys …

Dark humor in medicine: when coping becomes cruelty

Arthur Lazarus, MD, MBA

October 12, 2026Oct 12, 2026

An excerpt from METACINE: Essays on Health Care in a Changing World. Sometimes I use humor in my writing. Humor has always coexisted with suffering. In the high-stakes, emotionally draining world of medicine, comedy is rarely lighthearted. Instead, it takes…

An excerpt from METACINE: Essays on Health Care in a Changing World.

Sometimes I use humor in my writing. Humor has always coexisted with suffering. In the high-stakes, emotionally draining world of medicine, comedy is rarely lighthearted. Instead, it takes the form of gallows humor: a sharp, cynical, and dark style of joking that addresses illness, trauma, and death.

Medical professionals routinely encounter situations that would overwhelm a layperson. To cope …

Why I built a medical home model for military families

Ronald L. Lindsay, MD

October 12, 2026Oct 12, 2026

The Franklin Medal sits in a box in my attic. Most days I don't think about it. Life has a way of burying old honors beneath newer responsibilities. Yet every so often I remember that silver medal and what it…

The Franklin Medal sits in a box in my attic. Most days I don’t think about it. Life has a way of burying old honors beneath newer responsibilities. Yet every so often I remember that silver medal and what it represents.

I am not a descendant of Benjamin Franklin. I am one of his heirs.

More than two centuries ago, Franklin left money to the city of Boston to reward academic merit …

The scarlet letter O: a physician on Ozempic stigma

Robert Pretzlaff, MD, MBA

October 11, 2026Oct 11, 2026

Stop your moralizing. I grow weary of your superior airs. I am a 60-plus-year-old physician who has led a disciplined life. Despite going to the gym two to three times a week and with an acute awareness of my caloric…

Stop your moralizing. I grow weary of your superior airs.

I am a 60-plus-year-old physician who has led a disciplined life. Despite going to the gym two to three times a week and with an acute awareness of my caloric intake, I had been overweight for many years. I, along with nearly three-quarters of Americans, have committed the sin of being heavy. Today I have a BMI slightly above 25 and …

How to prepare for a doctor’s appointment and be heard

Terry Adirim, MD, MPH, MBA

October 11, 2026Oct 11, 2026

An excerpt from The Prepared Patient: Your Guide to Surviving the Health Care System. In today's health care system, patient-centered care often feels more like an unattainable ideal than a reality. Systemic inefficiencies seem to overshadow the promise of collaboration,…

An excerpt from The Prepared Patient: Your Guide to Surviving the Health Care System.

In today’s health care system, patient-centered care often feels more like an unattainable ideal than a reality. Systemic inefficiencies seem to overshadow the promise of collaboration, empathy, and individualized attention, while rushed appointments and fragmented communication prevail. The result? A disconnect between what patients need and what the system delivers.

One of the most significant barriers to …

Physician voices

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