Hospital Medicine

How night shift medicine exposes the reality of physician stress

Physician

April 2, 2026

At 2 a.m., the hospital is quieter but the stakes are not. A single page can alter the trajectory of a patient’s life. A subtle clinical shift can mark the difference between stability and decline. At night, there is less margin for error, fewer immediate resources, and no room for hesitation. Not long ago, I was called to evaluate a patient who “just did not look right.” The vital signs …

Finding purpose as an international medical graduate in the U.K.

Dr. Afsar Ashraf and Dr. Amal Pulikkal

Physician

April 1, 2026

The second time I landed in the U.K., the dream felt different. My first trip was for an exam; this time, it was for good. I walked into the arrivals hall with two bags. One was a worn suitcase packed with stethoscopes and textbooks. The other was invisible but far heavier, filled with my parents’ hopes and my wife’s unwavering faith.

In the bustling chaos of the international boarding area, after …

The Silent Variance: How patient friction destroys health care revenue

Donna Harvin‑Graham, MBA

Conditions and Diseases

March 28, 2026

As health systems move into the 2026 fiscal year, CFOs and hospital boards have already approved their operating budgets. Capital is set aside for oncology expansions, MRI upgrades, and EHR enhancements. Revenue projections are built on patient volume, reimbursement assumptions, and clinical trial enrollment targets.

On paper, the math works. The P&L looks stable.

After more than 20 years in enterprise operations and financial systems, I know budgets fail long before the …

Health care affordability crisis: lessons from the NYC nursing strike

Marc Henry Estriplet, MD, MPH

Physician

March 25, 2026

As a physician who lives and has practiced in NYC, the largest nursing strike in the city’s history has broken my heart. It has saddened me that our nurses could not be the heroes they truly are and that hospitalized patients experiencing some of the worst days of their lives had not received the best quality care that they could and should get.

And this is just the start of a …

A resident’s first surgery: When the patient teaches the doctor

Kaylan Baban, MD, MPH

Physician

March 21, 2026

“Dr. Baban? Dr. Baban?”

His slurred voice rasps across the room, weak but insistent, cutting through chiming monitors, buzzing fluorescent lights, and the screeching pager slung next to the empty gnaw in my stomach. I freeze where I stand, one hand scratching out post-operative orders on the last emergency surgery of the day, the other midway to the nursing station phone, grasping the silenced pager. My eyes sweep over the recovery …

Night shift health tips: How to protect your circadian rhythm

Chinyelu E. Oraedu, MD

Physician

March 12, 2026

When I started working the night shift as a nocturnist straight out of residency, no one prepared me for the physical and mental toll that lifestyle would take on my body. My motivation for pursuing this job opportunity was to spend my daytime hours with my young children: twin boys and my daughter all under five years old.

Night shift work keeps hospitals running, cities safe, and essential services moving while …

Why hospitals shouldn’t own physician practices: 6 key reasons

David Wild, MD

Physician

March 8, 2026

Over the past two decades, hospital systems have increasingly acquired physician practices, arguing that integration improves care coordination, lowers costs, and stabilizes struggling practices. In reality, this consolidation has often produced the opposite effect: higher costs, reduced physician autonomy, diminished innovation, and care that is less responsive to patients’ needs. While hospitals and physicians must collaborate closely, ownership is not collaboration, and hospital systems should not be in the business …

The Blanket Sign: Recognizing difficult patient encounters in the ER

George Issa, MD

Physician

March 4, 2026

It is honestly impressive the lengths people will go to cure their illnesses, or, alternatively, to lovingly nurture their favorite delusions. And to be fair, I get it. We have all been sick. I am a doctor and I have still Googled home remedies for canker sores, tooth pain, and ingrown toenails. The difference is that experimenting with saltwater rinses is unlikely to end your life.

When it comes to actual, …

“Disruptive” behavior is often a cry for help from depleted doctors [PODCAST]

The Podcast by KevinMD

Podcast

March 2, 2026

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

Pediatrician and certified coach Jessie Mahoney discusses her article “Disruptive physician labeling: a symptom of systemic burnout.” Jessie argues that the rising number of “disruptive” labels slapped on highly skilled doctors is …

Managing a Black Swan in health care: a lesson in transparency

Joseph Pepe, MD

Physician

February 2, 2026

An excerpt from On All Sides of the Bed: One physician’s/CEO’s journey.

In the early summer of 2013, our hospital collided with a Black Swan.

Before Europeans discovered Australia, they were familiar only with white swans. The discovery of black swans overturned a long-held assumption. In business and risk theory, a “Black Swan” refers to a rare, unpredictable event with massive consequences, a concept popularized by Nassim Nicholas Taleb. For us, …

Why clinical excellence isn’t enough to sustain a physician-owned hospital

Dr. Bhavin P. Vadodariya

Physician

January 27, 2026

Most physicians begin their careers with a deeply held belief: If treatment is good, patients will come. It feels intuitively correct, and early in practice it often appears to be true. Clinical outcomes build trust, trust brings patients, and for a time the system seems to sustain itself. Yet after years of working inside physician-owned hospitals, group practices, and large corporate health systems, I have learned an uncomfortable truth. Good …

How a pregnancy test on a male patient revealed health care flaws

Eric Goldfarb

Conditions and Diseases

January 20, 2026

My father’s last medical bill suggested he might be expecting a child. He was 88 years old. Somewhere in the hospital’s system, common sense had vanished. We found the pregnancy test charge only after paying the bill in full. My mother and I wrote to the hospital. The first reply was warm and procedural: Thank you for contacting us. We will submit this to Revenue Integrity. You should expect a …

Peacekeeping medicine: Saving lives in Sudan’s forgotten hospital

Benedicta Yayra Adu-Parku

Conditions and Diseases

January 2, 2026

When we think of peacekeeping missions, images of armored vehicles and blue helmets often dominate the narrative. Rarely do we picture the quiet, relentless battle fought within the walls of a makeshift hospital, where saving lives becomes an act of defiance against chaos. Yet, in Abyei, Sudan, that was our reality. We arrived expecting logistical challenges, but nothing prepared us for the disarray that greeted us at the UN Level …

The role of operations research in health care crisis management

Gerald Kuo

Conditions and Diseases

January 1, 2026

At the height of the COVID-19 surge, many hospital leaders faced moments they will never forget. Beds were nearly full. Staff were exhausted. Supplies that once felt routine suddenly became scarce. In those moments, decisions had to be made quickly, often based on experience, instinct, and whatever information was available at the time.

We like to believe that good leadership means trusting our gut. In clinical medicine, intuition matters. Years of …

When hospitals act like platforms, clinicians become content

Gerald Kuo

Conditions and Diseases

December 23, 2025

For years, hospitals have been urged to modernize. We are told to digitize workflows, optimize performance, and rely on dashboards and algorithms to improve efficiency. Much of this advice is reasonable. Medicine cannot function without systems.

But recently, while observing hospital transformation from within, I began to feel a familiar unease, one I had encountered before outside of medicine.

It reminded me of how digital platforms operate.

Platforms are not inherently unethical. They …

Physician night shifts: Analyzing the financial and personal trade-offs

Rob Anderson, MD

Physician Finance

December 11, 2025

I once promised myself confidently, and with the full arrogance of a seasoned attending, that I would never sleep another night in a hospital. I’d done my time. I’d earned my daylight. But life has a way of calling your bluff. A few years later, everything had shifted. I was divorced. My kids were older and more independent. My clinical career had settled into something comfortable, but predictable. I found …

The physician-nurse hierarchy in medicine

Jennifer Carraher, RNC-OB

Medical Education

December 5, 2025

When an attending doctor recently took me aside after a particularly hard clinical case with a first-year resident, she made pains to point out to me that the resident felt she wasn’t being treated fairly by nurses, because she was a woman. The physician went on to describe the difficulty of being a woman in a professional world where male colleagues are taken more seriously and treated with more respect, …

Community hospital innovation: a survival story

Gerald Kuo

Conditions and Diseases

December 4, 2025

Innovation in health care is often described in technological terms (new devices, advanced imaging, digital platforms). But some of the most meaningful forms of innovation happen quietly, inside small hospitals struggling to survive.

This is the story of a community hospital in Taiwan that once faced collapse, and the unexpected lessons it offers to health care leaders everywhere.

Looking for a way forward

In the late 1990s, the hospital was in serious decline. …

The erosion of evidence-based medicine: a doctor’s warning

Corinne Sundar Rao, MD

Physician

December 1, 2025

Something unsettling is happening in medicine, and many of us feel it even if we haven’t said it out loud: evidence-based medicine is slowly being eroded, not just by outsiders, but from within our own profession.

Patients today are searching more than ever before for quick fixes, and physicians are increasingly stepping into the marketplace to meet that demand. Hormone pellets. “Longevity protocols.” Peptides that sound scientific but have no real …

Language doulas bridge care gaps

Deepak Gupta, MD, Kaya Chakrabortty, and Yara Ismaeil

Physician

November 28, 2025

During health care encounters with patients from diverse linguistic and cultural backgrounds, there is always a concern about information getting lost in translation between health care providers and their patients. Language and cultural concordance significantly affect the quality and effectiveness of health care delivery. Although phone-in interpreters, with or without video capabilities, are accessible online, none can match in-person interpretation. Even if high-profile political conversations have adapted to artificially intelligent …

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Language doulas bridge care gaps