Primary Care

Rebuilding patient trust when medical advice is resisted

Physician

May 10, 2026

I would like to share with readers a story about a clinical encounter that challenged my ability to build trust amid fear and misunderstanding. As a practicing physician and medical educator, I have long been drawn to the emotional and ethical dimensions of patient care. While the story itself is not unique, it captures a recurring tension in our work, the gap that can emerge between clinical expertise and patient …

Why we must fix our fragmented health care system architecture

Vance Alm, MD

Physician

May 7, 2026

Last year I watched a patient of mine, I will call him Raymond, navigate what should have been a straightforward referral to cardiology. He had insurance. Good insurance. The kind politicians point to when they say the system is working. It took 11 weeks, four phone calls, two prior authorizations, and one emergency department (ED) visit to get him seen. He was not uninsured. He was not poor. He was …

Prior authorization during surgery is not oversight

Steven E. Warren, MD, DPA

Physician

May 7, 2026

She was forty-eight years old and had already been through enough.

Her uterus had prolapsed. If you have not heard the term, let me be plain. The uterus had descended through the vaginal opening. It was outside her body. This is not a metaphor and it is not a minor complaint. It is a complete structural failure of the pelvic floor that turns walking, sitting, and basic dignity into a daily …

Patients don’t need certainty, they need your reasoning out loud [PODCAST]

The Podcast by KevinMD

Podcast

May 6, 2026

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

What if the biggest driver of unnecessary ER visits, malpractice claims, and patient anxiety isn’t a missed diagnosis but a missed sentence? Alan P. Feren, a retired surgeon, independent physician, health care consultant, …

How vocal biomarkers are revolutionizing early detection

Kang Hsu, Jr., MD

Conditions

May 6, 2026

Early detection has always been one of medicine’s most powerful tools. The sooner we can identify cognitive, behavioral, or neurological conditions, the greater the potential benefit for patients, their caregivers, and their providers. That truth is even more pressing today. Thanks to rapid advances in artificial intelligence and speech analysis, vocal biomarkers have emerged as a fast, accurate, and non-invasive way to screen for a growing range of conditions. The …

Why physicians treat symptoms not causes of disease

Tomi Mitchell, MD

Physician

May 5, 2026

I have come to a realization, one that has been building quietly over years of practice, long before I had the language to articulate it fully. We are very good at doing what we were trained to do. And yet, something about what we are doing is not enough.

As physicians, we are exceptionally skilled at identifying symptoms, categorizing them, and intervening with precision. We move quickly. We think algorithmically. We …

The silent burden in health care and administrative waste

Donna Harvin‑Graham, MBA

Conditions

May 4, 2026

In every operational environment I have worked in, labor is visible. It is assigned, measured, and supported. Health care is the only sector where the system routinely generates work it does not staff, does not track, and does not claim. Instead, that work is absorbed by patients, clinicians, and caregivers who carry it because the alternative is delay or failure. This quiet transfer of labor is what I call the …

How political divisiveness impacts your health and well-being

Mark F. Sullivan, MD

Physician

May 4, 2026

Physicians are trained to listen for symptoms that point to deeper problems. For example, chest pain can mean heart disease, and ongoing fatigue might signal depression or another illness. I once cared for a middle-aged teacher who showed how political divisiveness can affect health. She came in with headaches and trouble sleeping. While we spoke, she shared that her symptoms got worse during heated political debates at her school and …

Why artificial intelligence displacement threatens medical specialties

H. Michael Boulton, MD

Physician

May 3, 2026

Diagnostic radiology, as a physician-staffed specialty, will not exist in its current form within 20 years. Neither will diagnostic pathology. Neither, in all likelihood, will the outpatient model of endocrinology or general internal medicine as we currently understand it. These are not fringe predictions from technologists who have never set foot in a hospital; they are the logical endpoint of capability curves …

I Googled my own name and a corporate clinic I’ve never worked at appeared [PODCAST]

The Podcast by KevinMD

Podcast

May 2, 2026

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

What happens when a physician searches her own name online and gets redirected to a billionaire-backed corporate clinic she has no connection to? Stephanie Waggel, a physician and …

AI is already reading your dental X-rays and you probably have no idea [PODCAST]

The Podcast by KevinMD

Podcast

May 1, 2026

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

When was the last time your dentist mentioned that artificial intelligence was scanning your X-rays before you even sat down in the chair? General dentist Sowjanya Gunukula explains how …

Shared responsibility in patient care needs boundaries

Alan P. Feren, MD

Physician

April 30, 2026

At the end of a visit, it is common to say: “Call if things get worse.” It sounds supportive. It sounds open-ended. It sounds safe. But what does “worse” mean? More frequent pain? More intense pain? Pain that wakes the patient at night? Pain that interferes with work? Without definition, responsibility shifts quietly.

Modern care depends on patients, not simply to follow instructions, but to understand the treatment plan, to carry …

Why our health care system is failing chronic disease patients

Beata Pasek, EdD

Conditions

April 30, 2026

Chronic disease is rising. Our system is not designed for it. This is not a controversial observation. Across clinical practice, research, and health system leadership, there is growing recognition that the burden of chronic illness is increasing and beginning earlier in life. What is less often acknowledged is that the structure of our health care system has not evolved at the same pace. In clinical settings, this shift is already …

He declined routine X-rays and was denied a dental cleaning [PODCAST]

The Podcast by KevinMD

Podcast

April 28, 2026

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

What happens when a patient makes a reasonable, informed decision to skip a non-mandatory test and the system simply stops? Patient advocate Aaron S. Rosenberg shares how a routine dental visit became a …

Why patient understanding is the missing metric in medicine

Joseph A. Rotella, MD, DC

Physician

April 28, 2026

A patient nods. You explain the diagnosis. You review the plan. You answer questions. You feel like the visit went well.

“Any questions?” you ask.

“No, I am good.”

They leave. And if you are honest, there is a moment, sometimes fleeting, sometimes not, where you wonder: Did they actually understand any of that? As you know, you have to pick up the pace to see another patient. In modern medicine, we measure …

She donated 2,000 hours of unpaid labor before she even noticed [PODCAST]

The Podcast by KevinMD

Podcast

April 27, 2026

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

When did volunteering stop being a choice and start being a condition of professionalism? Pediatrician, certified coach, and mindfulness and yoga teacher Jessie Mahoney realized she had donated over 2,000 hours of uncompensated …

Why the U.S. needs more preventive medicine and public health doctors

Jacob Player, MD, MPH

Policy

April 26, 2026

“What is that?” I was sitting in the emergency room during my emergency medicine rotation, chatting with my attending when he had asked me what residency program I was in. I told him I was actually doing two: family medicine and preventive medicine. Family medicine he had heard of, but preventive medicine? Only a confused look. And he is not the only one. In medical school, there was no specialty …

13.1 reasons running a half marathon beats practicing medicine

John Wei, MD

Physician

April 25, 2026

This past weekend, I completed the United Airlines NYC Half Marathon, a 13.1-mile course running across the Brooklyn Bridge, through the streets of New York, through Times Square and Central Park, finally finishing upright and with both shoes still on. In the 48 hours since crossing the line, I have reflected deeply on the experience and arrived at one inescapable conclusion: It was still better than going to work. Please …

His mother-in-law heard “cancer,” went home, and was dead within a year [PODCAST]

The Podcast by KevinMD

Podcast

April 24, 2026

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

What happens when a doctor closes the chart but the patient leaves without understanding what was actually said? Retired surgeon, independent physician, health care consultant, and patient advocate Alan …

Physician autonomy is not separate from patient care

Corinne Sundar Rao, MD

Physician

April 22, 2026

Recently, I came across the Charter of the Soignés (“those being cared for”) by French physician and writer Martin Winckler from The School of Caregivers (2019).

This is not a legal document, but an ethical framework. It outlines 10 principles centered on dignity, autonomy, and the humanity of the patient.

The first nine principles focus on what we would hope our patients experience. The recognition that a person is more than a …