KevinMD.com

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 …

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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, 2026

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, 2026

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 …

Health policy

Who should patients call about confusing medical bills?

Naor Jacoby

November 1, 2026Nov 1, 2026

A patient receives a hospital bill and does what every responsible article tells them to do. They check it. They see room charges, imaging charges, pharmacy charges, supplies, insurance adjustments, and a final patient balance. Some lines look familiar. Some…

A patient receives a hospital bill and does what every responsible article tells them to do. They check it.

They see room charges, imaging charges, pharmacy charges, supplies, insurance adjustments, and a final patient balance. Some lines look familiar. Some look duplicated. Some look excessive. Some may not even be bills, but explanations of benefits that look like bills.

So the patient calls the hospital and says, “This seems too high.” The …

Medical education

What patients teach us about humanism in medicine

Ananya Raghavan

November 1, 2026Nov 1, 2026

As an aspiring doctor who has worked with many different patients across New York City, I'm primed to think of health care delivery as the following: Note the symptoms, diagnose the condition, treat and hope for recovery. Once, I met…

As an aspiring doctor who has worked with many different patients across New York City, I’m primed to think of health care delivery as the following: Note the symptoms, diagnose the condition, treat and hope for recovery.

Once, I met a little girl who changed my thinking entirely. She was nine, dressed in neon pink shoes with a matching backpack. Unlike most girls her age, she had a prosthetic eye, implanted …

Conditions and diseases

TMS and esketamine work. Community clinics are the test.

Ravi Singareddy, MD

November 1, 2026Nov 1, 2026

For most of the past two decades, community practice has managed treatment-resistant depression (TRD) the way STAR*D described: one medication after another, with remission rates falling below 15 percent by the third trial. Repetitive and deep transcranial magnetic stimulation (TMS), FDA-cleared since 2008, and intranasal esketamine (Spravato), approved in 2019, have changed what a community psychiatrist can offer. In pooled trial data and in real-world cohorts, the two …

Conditions and diseases

Organ cryopreservation could ease the organ shortage

Rao M. Uppu, PhD

November 1, 2026Nov 1, 2026

Nature's own cryoengineering Here is the story of the wood frog, nature's cryoengineer, a little animal that many may find interesting. I talk about this often in my molecular toxicology class. The wood frog (Lithobates sylvaticus) lives across the northern…

Nature’s own cryoengineering

Here is the story of the wood frog, nature’s cryoengineer, a little animal that many may find interesting. I talk about this often in my molecular toxicology class. The wood frog (Lithobates sylvaticus) lives across the northern United States and Canada, all the way into Alaska. It is one of the few amphibians known to live north of the Arctic Circle. What makes this frog special is something …

Health technology

Why AI trained on clinical notes misses the medicine

John C. Ferguson, MD

November 1, 2026Nov 1, 2026

Six weeks into my internship, on a Sunday morning at the VA, I ran my first code. The patient was POD#5 from a CABG and going home that day. The cardiothoracic attending had rounded early and pulled his pacing wires.…

Six weeks into my internship, on a Sunday morning at the VA, I ran my first code.

The patient was POD#5 from a CABG and going home that day. The cardiothoracic attending had rounded early and pulled his pacing wires. I had never met the attending. I had never met the patient. I got called because the man went into afib while getting dressed.

The floor nurses weren’t permitted to push beta-blockers, …

The Podcast by KevinMD

Shy doctors can lead: imposter syndrome and the path to physician leadership [PODCAST]

The Podcast by KevinMD

October 31, 2026Oct 31, 2026

She never saw herself as a leader, and she was quiet and shy, yet she became a chief medical officer. Vidhya Prakash is an internal medicine physician and chief medical officer at SIU Medicine. This episode is based on her…

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Physician voices

Retiring from medicine felt like someone ate my sins

Vincent A. Keszei, MD

October 31, 2026Oct 31, 20263

I recently retired from practicing medicine after forty-three years, specifically in ophthalmology. Everyone I know seemed to bombard me with the same question: What's it like being retired? I've been thinking about and preparing for this moment for quite some…

I recently retired from practicing medicine after forty-three years, specifically in ophthalmology. Everyone I know seemed to bombard me with the same question: What’s it like being retired? I’ve been thinking about and preparing for this moment for quite some time. In the final days, I saw my last patient, relinquished my license and staff privileges, and completed withdrawal from all insurance plans. My family and I had a small …

Physician voices

Physician retention fails when toxic culture goes unchecked

Tomi Mitchell, MD

October 31, 2026Oct 31, 2026

If every physician in your organization woke up tomorrow with complete financial freedom, how many would still choose to stay? It is a simple question, but the answer could reveal more about your organization than any employee engagement survey or…

Remove the mortgage payments, student loans, family expenses, and financial obligations that keep people working, and what remains? Would physicians still choose to practice in your organization because …

Physician voices

What kids really get from AI for emotional support

Timothy Lesaca, MD

October 31, 2026Oct 31, 2026

Kate Schweitzer's October 2026 JAMA article examines children's growing use of artificial intelligence and reports that, in a large Ontario survey, over one in five students used AI for emotional support or advice. Of these students, about 58 percent showed…

Kate Schweitzer’s October 2026 JAMA article examines children’s growing use of artificial intelligence and reports that, in a large Ontario survey, over one in five students used AI for emotional support or advice. Of these students, about 58 percent showed signs of emotional problems, compared to 29 percent of those who didn’t use AI. The article explains why chatbots have appeal: they’re easy to access, usually free, and can feel …

Physician finance

Why patient no-shows are really a rescheduling problem

Kyle Morham

October 31, 2026Oct 31, 2026

Specialty practices often treat no-shows as an unavoidable result of patients forgetting, getting busy, encountering transportation issues, or changing their minds. But persistent no-shows may signal problems with the patient experience. Patients can rebook a flight from their phone at…

Patients can rebook a flight from their phone at midnight, yet changing a medical appointment may require a call during business hours. Friction across booking, confirmation, rescheduling, and cancellation can turn inconvenience into a recurring operational problem. For specialty practices, …

Real physician voices, twice a week

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