KevinMD.com

October 21, 2026Oct 21, 2026

When you can't speak for yourself, a living will is supposed to speak for you. Too often, it doesn't. Seventy percent of U.S. adults don't have one, and those who do often keep it in a drawer at home. Emergency…

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When you can’t speak for yourself, a living will is supposed to speak for you. Too often, it doesn’t. Seventy percent of U.S. adults don’t have one, and those who do often keep it in a drawer at home. Emergency physician and MIDEO Health Technologies CEO Ferdinando Mirarchi and attorney …

Physician voices

Is teen anxiety normal or a disorder? Both answers can fail.

Timothy Lesaca, MD

October 21, 2026Oct 21, 2026

Teenage anxiety is real, but if we treat every feeling as a medical issue, we might overlook what is truly important. When a teen says, "I'm anxious," we shouldn't have to choose between saying, "You have a disorder," or "That's…

Teenage anxiety is real, but if we treat every feeling as a medical issue, we might overlook what is truly important. When a teen says, “I’m anxious,” we shouldn’t have to choose between saying, “You have a disorder,” or “That’s just adolescence.” Both responses can shut down a conversation before it even starts.

A 2026 study in JAMA Pediatrics reveals this distinction. Analyzing 2024 National Survey on Drug Use and Health …

Medical education

Did I fail my first code as a medical student?

Afshine Ash Emrani, MD

October 21, 2026Oct 21, 2026

An excerpt from Beyond the White Coat: A Novel. Before I ever ran toward a code, I ran away from one. I was a fourth-year medical student at U.C. San Diego shadowing in the trauma bay when a man arrived…

An excerpt from Beyond the White Coat: A Novel.

Before I ever ran toward a code, I ran away from one.

I was a fourth-year medical student at U.C. San Diego shadowing in the trauma bay when a man arrived from a freeway accident, young, beautiful, golden even in blood. They called for compressions. I stood back, pressed against the wall, my hands gripping my clipboard like it might protect me …

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Patient voices

Learning to walk again after injury is not just physical

Anna Estrin

October 21, 2026Oct 21, 2026

Before my injury, my life revolved around fashion: runway shows, camera flashes, social events, and, almost always, high heels. I wrote about the fashion industry and treated walking as something the body simply did. Then a severe ankle fracture-dislocation and surgery changed the scale of an ordinary day. The heels gave way to a wheelchair. Success became taking a few steps.

I spent about three months in a wheelchair. I expected …

Health policy

Losing health insurance should not mean losing dignity

Katie Abbott, MHA

October 21, 2026Oct 21, 2026

At a recent health care conference, a panel of leaders gathered to talk about financial resilience. The framing was intentionally designed. The question wasn't "How do we save money?" It was "how to deliver the right care, at the right…

At a recent health care conference, a panel of leaders gathered to talk about financial resilience. The framing was intentionally designed. The question wasn’t “How do we save money?” It was “how to deliver the right care, at the right time, in the way that is most meaningful, so that outcomes change, health improves, and the total cost of care comes down.”

When the audience asked how social and structural drivers …

Physician finance

A medical license scam nearly took my life savings

Lynn R. Webster, MD

October 21, 2026Oct 21, 2026

As a physician, I spent decades training to manage medical crises, yet I nearly lost my life savings to a calculated deception. The caller offered me two ways to protect my assets: convert everything to gold and take it to…

As a physician, I spent decades training to manage medical crises, yet I nearly lost my life savings to a calculated deception.

The caller offered me two ways to protect my assets: convert everything to gold and take it to Washington, D.C., for deposit with the Department of the Treasury, or convert everything to digital currency.

By then, I had spent nearly three weeks communicating with people I believed might be investigating …

Health policy

Why medical malpractice reform keeps dying in Congress

Howard Smith, MD

October 21, 2026Oct 21, 2026

I intend to prove four things: (1) The nation is at the tipping point of socialized medicine. (2) Medical malpractice lawsuits tip the scale. (3) Lawyers have their fingers on the scale and are to blame. (4) The American people…

The consequence of these four things is exemplified in 2017 with HR 1215, the Protecting Access …

Conditions and diseases

Multifidus dysfunction is the back pain cause we overlook

Francisco M. Torres, MD

October 21, 2026Oct 21, 2026

For most of my career, I was content to blame chronic low back pain on the usual suspects: discs, joints, nerve roots, and the ever-mysterious soft tissue. That was the prevailing wisdom, and I’ll admit, it served me well enough for a long time. But as both the literature and my years in the clinic have evolved, I’ve had to acknowledge a less obvious but essential player: the lumbar spine’s …

Health technology

A satire on AI bedside manner in an automated hospital

Richard Gibula, MD

October 21, 2026Oct 21, 2026

I woke up in an emergency room with the robotic nurses surrounding me. They were all scrambling around with IVs, blankets, pillows, and, yes, bladder tubes. The atmosphere was a little icy since there were no expressions on their faces and they did not answer any of my questions. All I could remember is that I passed out at work. I don’t even know which hospital I’m in. There were …

Physician voices

Why a pre-med took the physics course meant for majors

Ronald L. Lindsay, MD

October 21, 2026Oct 21, 2026

When I arrived at Boston University in 1975, I carried more than a class schedule. I carried doubts. I had graduated from English High School in Boston during the turbulent years of court-ordered desegregation. Although I had performed well academically,…

When I arrived at Boston University in 1975, I carried more than a class schedule. I carried doubts.

I had graduated from English High School in Boston during the turbulent years of court-ordered desegregation. Although I had performed well academically, I knew many people viewed graduates of urban public schools as less prepared than students from elite suburban schools and prestigious private academies.

Medical schools would eventually decide whether I was qualified. …

Medical education

Trauma-informed consent does not end when the exam begins

Michael Duell

October 21, 2026Oct 21, 2026

She wanted treatment. She understood why she needed it. But when it came to the intimate part of her care, she struggled to continue. The patient had survived sexual assault. Now, years later, medically necessary treatment required her to expose…

She wanted treatment. She understood why she needed it. But when it came to the intimate part of her care, she struggled to continue.

The patient had survived sexual assault. Now, years later, medically necessary treatment required her to expose her body, tolerate intimate examination, and surrender some degree of physical control to people she rarely knew.

By the conventional markers of informed consent, nothing appeared to have gone wrong. The treatment …

The Podcast by KevinMD

Memory loss is not normal aging, and waiting costs the treatment window [PODCAST]

The Podcast by KevinMD

October 20, 2026Oct 20, 2026

Someone tells you their memory is slipping. What you say next can decide whether treatment is still an option for them. Emer MacSweeney is a neuroradiologist and the cofounder and CEO of Re:Cognition Health. This episode is based on her…

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Physician finance

Physician debt and the myth of the rich doctor

Bruno Casanova, MD

October 20, 2026Oct 20, 2026

As soon as you become a doctor you will be faced with an entire industry encouraging you to take on debt. They rely on the promise of your future high income. And I am not talking about student loans, that is a completely different beast. I am referring to that nice person smiling at you while you ponder whether to buy a brand-new car whose value will melt faster than …

Conditions and diseases

What a reassuring sepsis screening score can hide

Dr. Gautam Kumar Panjiyar

October 20, 2026Oct 20, 2026

Sepsis remains one of the most time-critical diagnoses an emergency physician can miss. Every hour that antibiotic administration is delayed after the onset of septic shock has been linked to rising mortality, yet the very tools designed to flag sepsis early, the quick Sequential Organ Failure Assessment (qSOFA) foremost among them, have come under growing scrutiny for missing patients until they are already critically unwell. Since the Sepsis-3 consensus introduced …

Physician voices

A doctor with bipolar disorder: reflections on medicine

Dr. Angelika Luehrs

October 20, 2026Oct 20, 2026

During my medical training in 2004, I was diagnosed with bipolar affective disorder. Prior to my diagnosis, a consultant had told me that having a mental illness recorded in my medical notes would mean the end of my career in medicine. He was wrong. I received treatment, completed my training, and became a consultant psychiatrist.

My interest in psychiatry began before my own diagnosis. I was attracted to a specialty that …

Medical education

Why the ACGME proposal threatens resident duty hours

Dayna Isaacs, MD, MPH & Shireen Saxena, MD

October 20, 2026Oct 20, 2026

Physicians have until October 22, 2026, to weigh in on proposed Accreditation Council for Graduate Medical Education (ACGME) changes that would threaten longstanding intern, resident, and fellow work-hour safeguards. The stated ACGME goal is greater flexibility. The question is: flexibility…

The stated ACGME goal is greater flexibility. The question is: flexibility for whom?

Released on September 8 as part of a major revision to the Common Program Requirements for Residency, the proposal would:

Eliminate the 8-hour rest recommendation between shifts completely (§6.30).
Eliminate the

…

Drugs and prescribing

Testosterone for women belongs in the female range

Michael Duben, MD

October 20, 2026Oct 20, 2026

I am a board-certified endocrinologist with over twenty years of clinical experience and training in functional medicine. I trained when hormone replacement was gospel, and I have practiced through every swing of the pendulum since. So here is the thesis…

So here is the thesis first, because it is short. A woman’s testosterone belongs in the female range. For most women, not even at the top of it. For no woman, ever, in the male range.

Small …

Conditions and diseases

Reconstructive surgery after burns or trauma is gradual

Dr. Ali Adil

October 20, 2026Oct 20, 2026

When burns or traumatic injuries change the appearance or function of the body, patients often face decisions while they are still processing pain, fear, and uncertainty. Reconstructive surgery may help restore movement, protect damaged tissue, improve wound healing, or address changes in appearance. It is not a single procedure or a promise to return the body exactly to its previous state. A responsible decision begins with understanding the goals, timing, …

Health technology

Alert fatigue is a design problem, not a vigilance problem

Thomas Powell, MD

October 20, 2026Oct 20, 2026

Any safety system that is ignored 96 percent of the time is not an effective safety system. It is only a record that the alert fired, and the clinician did not act. Override rates on drug safety alerts consistently run…

Any safety system that is ignored 96 percent of the time is not an effective safety system. It is only a record that the alert fired, and the clinician did not act.

Override rates on drug safety alerts consistently run between 49 percent and 96 percent, depending on the alert and the setting. This fact has been repeated and has strong data. The usual reading of those numbers is that physicians …

Conditions and diseases

Finding your voice in medicine when you’d rather listen

Dr. Loshi Rajen

October 20, 2026Oct 20, 2026

When I was a child, my mother left a poem that had touched her under the glass screen of my study table. It was the poem of the wise old owl, and at the bottom, the author was stated as…

When I was a child, my mother left a poem that had touched her under the glass screen of my study table. It was the poem of the wise old owl, and at the bottom, the author was stated as anonymous.

I was all but six at the time. I learned a new word: anonymous. But that is not the point of this essay. The point is that my mother told …

Real physician voices, twice a week

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