KevinMD.com

The dangers of vertical integration in health care

Policy

March 11, 2026

As a practicing physician who has worked in the health care field in five different countries, I have a pretty solid idea of why health care in the U.S. is so problematic. In the U.S., many entities related to health care are owned by the same companies. This is a concept called vertical integration, where one business controls every stage of the supply chain. To understand this, imagine the car …

Securing physician autonomy with employer-sponsored direct primary care

Dana Y. Lujan, MBA

Physician

March 11, 2026

I play Go. Not chess. Not checkers. Go: the ancient strategy game where the objective is not to capture pieces but to claim territory. In chess, you attack. In checkers, you jump. In Go, you place. Each stone lands quietly. Each position builds on the last. The opponent is still arguing about three moves ago while the board is already decided. The board has been built one placement at a …

The mathematics of merit: Quantifying bias in medical malpractice

Howard Smith, MD

Physician

March 11, 2026

Most medical experts in medical malpractice are influenced by bias. Yet, they produce a certificate of merit. There are many types of biases, but I concentrate on only those biases that represent a systematic distortion that directly undermines the reliability of certainty in data and are measured by Type I and Type II errors.

Under this circumstance, merit can be regarded as certainty minus those biases. Those biases are selection bias, …

When a code blue happens on a psychiatry unit

Devina Maya Wadhwa, MD

Conditions

March 11, 2026

The overhead call still feels wrong when it happens on a psychiatry unit. Code blue. The words echo through hallways designed for containment and calm, not cardiac arrest. Psychiatry is supposed to be about listening, de-escalation, and meaning-making. A code blue interrupts that narrative abruptly, reminding everyone in earshot that bodies, not diagnoses, ultimately set the terms. What struck me most was not the urgency of the response (clinicians are …

Medical relevance and evolution: Why physicians must reinvent themselves

Adam Bitterman, DO

Physician

March 11, 2026

Medicine is a field defined by constant evolution. Advances in technology, groundbreaking research, and shifting patient expectations continually reshape the landscape of health care. As physicians, we are entrusted with providing excellent care. But we must also ensure that our knowledge, skills, and approaches remain at the forefront of this ever-changing environment. Staying up to date isn’t just a professional obligation, but a necessity to remain effective and relevant in …

Why quality of life in health care is often overlooked

Jeffrey Junig, MD, PhD

Conditions

March 11, 2026

I switched beta blockers a few days ago. Four or five, maybe. Nothing dramatic. No crisis. No near-miss. But my fingers are warm again, for the first time in months. And I’m sleeping better than I have in a long time. Those aren’t headline outcomes. They’re not the things medicine congratulates itself for. They are just noticeable. Modern medicine is very good at preventing death. It’s less good at noticing …

Navigating the patchwork of CME requirements by state

Vladislav Tchatalbachev, MD

Physician

March 11, 2026

I hold medical licenses in multiple states. As a teleradiologist, I have to; it is the nature of the work. What I did not fully anticipate was how much time I would spend navigating the patchwork of continuing medical education (CME) requirements that vary significantly from state to state.

The variation in numbers

In Montana, the state requires exactly zero hours of CME for license renewal. Drive across the border to Washington, …

Understanding the science behind embryo grading improves IVF decision making [PODCAST]

The Podcast by KevinMD

Podcast

March 10, 2026

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

Double board-certified obstetrician-gynecologist and reproductive endocrinology and infertility specialist Erica Bove discusses her article “A clinician’s guide to embryo grading in IVF.” Erica breaks down the complex metrics used to evaluate embryo …

Unfinishedness in medicine: When a good visit feels incomplete

Alan P. Feren, MD

Physician

March 10, 2026

Most clinicians can recall a visit that technically went well, and still didn’t feel finished.

The history was taken. The exam was appropriate. High-risk diagnoses were reasonably excluded. The plan followed guidelines. The note was clean. The visit ended on time.

And yet, something lingered. Not alarm. Not guilt. Something quieter and more familiar.

We rarely talk about this state in medicine, even though we encounter it daily. We have names for missed …

Why the FDA regulations on peptide therapy matter

Vikas Patel, MD

Meds

March 10, 2026

Everyone wants peptides, do you not? That includes Health and Human Services Secretary Robert F. Kennedy Jr. Last week, he announced on the Joe Rogan Experience that the FDA would reverse its restrictions on roughly 14 peptides that were banned from compounding pharmacies in 2023. “My hope is that they’re going to get moved to a place where people have access from ethical suppliers,” he told Rogan, while acknowledging, in …

Menopause and the drop in cervical cancer screening

Nenrot S. Gopep, MD, MPH

Conditions

March 10, 2026

Cervical cancer is one of the few cancers we actually know how to prevent. With HPV vaccination, routine screening, and early treatment of precancerous lesions, the disease is largely avoidable. Yet every year, thousands of women still develop cervical cancer, including about 14,000 women in the U.S. alone. When people think about cervical cancer prevention, the focus is usually on younger women: HPV vaccination for adolescents and Pap smears during …

Physician burnout definition: Why it is blocked energy, not just exhaustion

Susan MacLellan-Tobert, MD

Physician

March 10, 2026

Most physicians experience burnout as exhaustion. We say, “I have nothing left.” The assumption is simple: We are depleted, and what we need is rest. But after decades in medicine, and years of listening carefully to burned-out clinicians, I wonder if that assumption is wrong.

What if burnout is not a lack of energy at all? What if it is energy that has nowhere to go?

Physicians enter medicine with extraordinary life …

Pharmaceutical advertising ethics: Why TV drug ads mislead patients

M. Bennet Broner, PhD

Conditions

March 10, 2026

Previously, I wrote about the patient’s responsibility to gain knowledge about their condition and treatments, and how this is not always easy to do. This is increasingly important, however, as clinicians have decreased time with patients for reasons often beyond their control.

This need for knowledge applies not only to medical visits, but also to advertisements for nostrums (e.g., Neuriva) and for legitimate drugs. Both create enticing visions on TV and …

Why implementation is not the same as readiness in health care

Tiffiny Black, DM, MPA, MBA

Conditions

March 10, 2026

Health care leaders often declare change a success long before the people inside the system feel steady again.

New technologies go live. Policies are implemented. Metrics stabilize. From an operational standpoint, the work appears complete. Yet beneath the surface, distress lingers, silence deepens, and trust erodes.

This paradox is becoming increasingly familiar to clinicians: Change is labeled “successful,” but the human experience tells a different story.

The problem is not resistance.
It is not …

AI redefines the physician’s role by reducing cognitive overload [PODCAST]

The Podcast by KevinMD

Podcast

March 9, 2026

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

Family physician and health care entrepreneur Tod Stillson discusses his article “AI in medicine: Why it won’t replace doctors but will redefine them.” Tod argues that the binary debate between AI as …

Physician neutrality: a beacon of ethics in a divided world

Farid Sabet-Sharghi, MD

Physician

March 9, 2026

I watched with horror, grief, and tears in my eyes as the events of the last week unfolded. We witnessed a catastrophic massacre of Iranians seeking nothing more than the basic freedom to exist outside an oppressive system. As conflicts ignite in various corners of the world, it feels as though the fabric of our global society is tearing at the seams.

Yet, amidst the darkness, there was a silver lining: …

Pharmaceutical advertising dangers: Why drug ads hurt patients

George Issa, MD

Physician

March 9, 2026

One of the absolute worst ideas anyone in the government ever had was letting pharmaceutical companies advertise directly to the public. A public with roughly zero medical knowledge. A public that believes any weird twinge, sneeze, or momentary fatigue is a death sentence. We need that miracle pill, now! For our constipation, insomnia, erectile dysfunction, mysterious rashes, or the inevitable blood clot that we just know is coming.

These ads don’t …

How to handle clinical disagreement with patients

Muhamad Aly Rifai, MD

Physician

March 9, 2026

One of the hardest moments in medicine is not making a diagnosis. It is not writing the prescription. It is sitting across from a patient who wants something you do not believe is right for them and knowing that whatever you say next will either build trust or break it. That moment comes every day in modern practice. A patient wants an antibiotic for a virus. A patient wants a …

The economic shift from fee-for-service to direct primary care

Dana Y. Lujan, MBA

Policy

March 9, 2026

According to the Primary Care Collaborative, primary care accounts for roughly 5 percent of health care spending, yet it influences nearly 90 percent of downstream costs. That statistic is not a compliment. It is a diagnosis. And for a profession that has spent decades accepting influence as a substitute for economic ownership, it is long past time to read it that way. For decades, physicians …

The quiet paradox of physician mental health and medication

Timothy Lesaca, MD

Physician

March 9, 2026

Physicians are trained, above all, to project steadiness. Long before we feel it, we learn to perform it. The lesson begins early in training. The pager goes off, a room fills with urgency, and the expectation is unspoken but unmistakable: Remain calm. Do not let uncertainty show. Do not let fear show. Patients need confidence. Teams need direction. Over time, the composure stops feeling like a performance. It becomes a …

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts