KevinMD.com

November 3, 2026Nov 3, 2026

As physicians head to the polls, we are afraid for our patients and our profession. We are in a moment of extraordinary turbulence. Administrative overload, political intrusion into clinical care, workforce shortages, hospital and program closures, and public distrust have…

The future of medicine will be shaped by more than who wins at the ballot box. Our elected officials need not only …

Physician voices

Medical malpractice lawsuits need a test for merit

Howard Smith, MD

November 3, 2026Nov 3, 2026

Medical malpractice lawsuits make doctors very vulnerable in an unsettling future. Since the 1960s, medical malpractice lawsuits caused the unmitigated failure to control health care costs. Even today we have no idea of the number of medical malpractice lawsuits filed each year and, least of all, how many of these lawsuits are non-meritorious. Likely it is intended for us not to know because whatever is measured is managed and those …

Patient voices

Health care fears the informed patient. It shouldn’t.

Jessica Chalk

November 3, 2026Nov 3, 2026

For six years, I carried my medical history into every new appointment. The content wasn't in a medical record. It was in my head, in notes on my phone, in a spreadsheet I had assembled. Fertility treatment had failed repeatedly,…

For six years, I carried my medical history into every new appointment. The content wasn’t in a medical record. It was in my head, in notes on my phone, in a spreadsheet I had assembled. Fertility treatment had failed repeatedly, my diagnosis was unexplained, and I had no way of knowing which detail a new specialist would need. So I found myself recounting all of it, from the beginning, every …

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Physician voices

Are civilian hospitals ready for 1,000 war casualties a day?

Kaitlin Rainwater-Lovett, PhD, MD & Matthew Turner, MD

November 3, 2026Nov 3, 2026

The looming threat of LSCO It has been decades since the United States has experienced sustained, high-casualty large-scale combat operations (LSCO) at the level of the Second World War, the Korean War, and Vietnam. However, in the changing geopolitical landscape,…

The looming threat of LSCO

It has been decades since the United States has experienced sustained, high-casualty large-scale combat operations (LSCO) at the level of the Second World War, the Korean War, and Vietnam. However, in the changing geopolitical landscape, the possibility of the U.S. entering LSCO is high. Within the next decade, these conflicts are most likely to be with near-peer adversaries in complex, austere, and ambiguous environments.

In …

Conditions and diseases

TMS vs. Spravato: which to try first for depression

Ravi Singareddy, MD

November 3, 2026Nov 3, 2026

Most of us know the moment. A patient has failed two, sometimes three, adequate antidepressant trials, maybe an augmentation agent too. They are still depressed, often demoralized, and now asking, sometimes skeptically, what comes next. For two decades, the honest…

For two decades, the honest answer was “another medication,” with modest expectations. In STAR*D, fewer than 15 percent of patients reached remission with a third medication trial. Two FDA-authorized options have changed that conversation: transcranial magnetic …

Health policy

Genetic screening should not wait for a health crisis

Keelee Moseley, MBA

November 3, 2026Nov 3, 2026

Pregnancy. Marriage. A cancer diagnosis. A sick child. A family tragedy. Too often, something must happen before we start asking what our DNA might tell us. It shouldn't. Genetic screening and education should become a more normal and accessible part…

Pregnancy. Marriage. A cancer diagnosis. A sick child. A family tragedy. Too often, something must happen before we start asking what our DNA might tell us.

It shouldn’t. Genetic screening and education should become a more normal and accessible part of preventive health care, available before a life event or health crisis makes the information urgent.

We already practice prevention. We check blood pressure before a stroke. We measure cholesterol before a …

The Podcast by KevinMD

Physician pay won’t budge for one doctor. Negotiate as a group. [PODCAST]

The Podcast by KevinMD

November 2, 2026Nov 2, 2026

Many physicians are told their pay follows a standard plan that cannot change for one person. Jon Appino, a physician contract and compensation consultant at Contract Diagnostics, says administrators are often telling the truth. His firm is a central resource…

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Conditions and diseases

Why doctors should order the homocysteine test more often

Dan Purser, MD

November 2, 2026Nov 2, 2026

Every week I meet a patient who has already done everything "right." They've had the annual physical, the lipid panel, and the metabolic panel. They're still sick: tired, foggy, inflamed, and sometimes carrying a fatty liver that nobody can explain.…

Every week I meet a patient who has already done everything “right.” They’ve had the annual physical, the lipid panel, and the metabolic panel. They’re still sick: tired, foggy, inflamed, and sometimes carrying a fatty liver that nobody can explain. And nobody has checked their homocysteine or asked whether their methylation genetics might be part of the story.

I’ve come to believe that this gap is one of the more fixable …

Physician voices

Patient satisfaction surveys grade the wrong thing

Dr. Gurdev Singh

November 2, 2026Nov 2, 2026

Nearly every hospital in America now asks its patients a question that no sane person has ever asked a friend: Would you recommend us? It arrives a few weeks after discharge, in an envelope or an email, along with its…

Nearly every hospital in America now asks its patients a question that no sane person has ever asked a friend: Would you recommend us?

It arrives a few weeks after discharge, in an envelope or an email, along with its relatives. Did the doctors listen carefully? Was the area around your room quiet at night? Were the room and bathroom kept clean? On a scale of zero to ten, how would …

Physician voices

Self-driving cars are the assistive device nobody markets

Osama Jamil, MD

November 2, 2026Nov 2, 2026

An excerpt from Nobody's Driving: A Neurologist on the Self-Driving Century, and Why One Company Can't Be Allowed to Own It. The numbers vary by study, but somewhere between a third and two-thirds of stroke survivors are back behind the…

An excerpt from Nobody’s Driving: A Neurologist on the Self-Driving Century, and Why One Company Can’t Be Allowed to Own It.

The numbers vary by study, but somewhere between a third and two-thirds of stroke survivors are back behind the wheel within a year. Driving is one of the most demanding things an ordinary brain does: It requires cognition, perception, emotional control, and motor control, all at once, and a …

Health technology

Schizophrenia relapse prevention apps need a family contact

Nicole Drapeau Gillen

November 2, 2026Nov 2, 2026

A patient in a German schizophrenia trial got worse for weeks. The smartphone app built to catch it raised no alert during that stretch, because the worsening stayed just below its threshold. After declining a hospital admission, the patient stopped using the app and stopped answering calls. The care team found out what happened only when study staff phoned the family member listed as an emergency contact. The patient had …

Physician voices

Surgeon fatigue needs a fit-for-duty check, not hour limits

Colin G. Knight, MD

November 2, 2026Nov 2, 2026

Just after one in the morning on August 6, 1997, Korean Air Flight 801 was descending toward Guam in rain. The captain had been scheduled for a longer trip to Dubai, but he was not rested for it. The airline gave him the shorter run to Guam instead. About twenty minutes before the end, the cockpit voice recorder caught him talking about crew rest rules, and then, in a pause, …

Drugs and prescribing

Tirzepatide after bariatric surgery: what nobody asked me

Patience C. Ennis

November 2, 2026Nov 2, 2026

I have been a nurse for thirty-two years and have given hundreds of injections. In late September 2025, my GP, my primary care doctor here in Australia, sent me an electronic prescription for tirzepatide. I collected it from the pharmacy and gave myself the first injection. I did not read the leaflet. I knew how to give an injection, so I gave it.

Two days later, my tongue was sticking to …

Medical education

Pharmacy education should prepare students for real patients

Kirsty Affam

November 2, 2026Nov 2, 2026

As a PharmD student in Ghana, I entered clinical practice thinking that being prepared meant knowing my drugs well. I studied mechanisms of action, pharmacokinetics, adverse effects, interactions, and indications. I expected that when I entered the hospital, I would…

I quickly realized that real practice does not work that way. The patient is standing in front of …

Physician voices

5 facts about robotic surgery every patient should know

Dr. Homoud Aldahash

November 2, 2026Nov 2, 2026

When people hear "robotic surgery," they often imagine a machine performing a procedure by itself. The reality is far more human, and far more remarkable. As someone who recently performed the world's first intracranial robotic tumor removal, I've seen firsthand…

When people hear “robotic surgery,” they often imagine a machine performing a procedure by itself. The reality is far more human, and far more remarkable. As someone who recently performed the world’s first intracranial robotic tumor removal, I’ve seen firsthand how technology is transforming medicine. But it’s not what most people think. Here are five facts about robotic surgery that will help patients and the public better understand what it …

Physician voices

A test result is not the truth. Physicians forget that too.

Ronald L. Lindsay, MD

November 2, 2026Nov 2, 2026

Within hours of receiving two publishing rejections, I received a laboratory result that should have delighted me. My estimated glomerular filtration rate, or eGFR, was 86. Instead, I found myself staring at a different number. Ninety. Like many physicians, I…

Within hours of receiving two publishing rejections, I received a laboratory result that should have delighted me. My estimated glomerular filtration rate, or eGFR, was 86.

Instead, I found myself staring at a different number. Ninety.

Like many physicians, I know exactly how absurd that sounds. We spend our careers teaching patients not to obsess over single laboratory values. We explain that trends matter more than isolated data points. We urge them …

Fewer malpractice claims, bigger consequences: what physicians should know about today’s risk environment

MagMutual & William S. Kanich, MD, JD

November 2, 2026Nov 2, 2026

This article is sponsored by MagMutual. Malpractice claim frequency has been falling for years. Claim severity (the average cost of a paid claim) has been climbing just as steadily. Most physicians aren't aware of either trend, and understandably so. The…

This article is sponsored by MagMutual.

Malpractice claim frequency has been falling for years. Claim severity (the average cost of a paid claim) has been climbing just as steadily. Most physicians aren’t aware of either trend, and understandably so. The shift is happening in courtrooms, legislatures, and advertising budgets rather than in clinical practice. But they shape every physician’s exposure, whether …

Conditions and diseases

What causes the orgasm gap, and how can couples close it?

Neil Baum, MD & Sam Siddighi, MD

November 2, 2026Nov 2, 20262

Everyone, both men and women, deserves to experience an orgasm or the climax of sexual arousal. There are several disparities between men and women, including longevity between men and women, gender pay disparity, and orgasm disparity. The orgasm gap, or pleasure gap, is a social phenomenon referring to the general inequality between heterosexual men and women in terms of sexual satisfaction, more specifically, the unequal frequency in the achievement of …

Physician voices

A physician midlife crisis, charted in relative value units

Divya Rana, MD

November 1, 2026Nov 1, 20263

In any given year, working in the NICU brings its share of clinical challenges, heartaches, and spirit-lifting accomplishments. We're often the doctors whose "miracles" become someone else's "headache" once the baby moves to the PICU or the pediatric floor. Most…

In any given year, working in the NICU brings its share of clinical challenges, heartaches, and spirit-lifting accomplishments. We’re often the doctors whose “miracles” become someone else’s “headache” once the baby moves to the PICU or the pediatric floor. Most of the general public doesn’t know a place for sick newborns even exists, until they or someone they love lands there. I always tell my friends: I hope you never …

Health policy

Private equity replaced my anesthesia group. We can win.

Marco Fernandez, MD

November 1, 2026Nov 1, 2026

Every one of us learned the same lesson early: You cannot treat what you have not examined, and you cannot examine well without first taking a history. We diagnose and plan treatment from the history, the signs, and the symptoms.…

I believe the same is true of the system we practice in. Learning the history of our economics is as important as learning the …

Real physician voices, twice a week

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