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How night shift medicine exposes the reality of physician stress

Physician

April 2, 2026

At 2 a.m., the hospital is quieter but the stakes are not. A single page can alter the trajectory of a patient’s life. A subtle clinical shift can mark the difference between stability and decline. At night, there is less margin for error, fewer immediate resources, and no room for hesitation. Not long ago, I was called to evaluate a patient who “just did not look right.” The vital signs …

GLP-1 agonists and weight loss: Treating the disease, not the number

Richard M. Fleming, MD, PhD, JD

Conditions

April 2, 2026

Modern medicine loves numbers. LDL. A1c. BMI. Tumor diameter. Pounds lost. They are easy to measure, easy to track, and easy to celebrate. But none of them are the disease itself.

As GLP-1 prescribing accelerates and insurers increasingly define success by weight reduction, we are repeating a familiar mistake: Elevating a surrogate marker to the status of a biological endpoint.

BMI was never designed to diagnose disease in individuals. Adolphe Quetelet created …

How clinical reassurance impacts patient communication

Alan P. Feren, MD

Physician

April 2, 2026

In clinical practice, reassurance is both necessary and responsible. When a clinician says “nothing concerning,” it is rarely casual. It reflects a judgment: no immediate danger, no clear evidence of serious disease, no indication for urgent intervention. It is often the appropriate conclusion at that moment in time. But what happens to that statement after the visit ends is less often considered. Because outside the clinical context in which it …

The physician leadership transition: Moving beyond the exam room

Maia Carter, MD, MPH

Physician

April 2, 2026

An excerpt from The Leadership Prescription: How High-Performing Clinicians Become Visionary Leaders.

There I was in my habitual rhythm, seeing patients back-to-back and enjoying it. After all, seeing the patients was the fun part; the administrative burden that accompanied it was nauseating and heralded the real risk of burnout. The administrators regarded me as someone who could easily create rapport with the patients. I was the kind of physician who …

Balancing civil rights and trauma in an antisemitism investigation

Arthur Lazarus, MD, MBA

Physician

April 2, 2026

In the wake of the October 2023 Hamas attacks on Israel, allegations of antisemitism surged on American campuses, including at the University of Pennsylvania. In response, the Equal Employment Opportunity Commission (EEOC) launched a Title VII investigation and subpoenaed Penn for the names and contact information of faculty and staff affiliated with Jewish organizations and Jewish Studies programs. Penn resisted. Faculty groups intervened. The phrase that reverberated through court filings …

Lifestyle medicine support: Bridging the gap in patient care

Landen Green, DO

Physician

April 2, 2026

As physicians, we rarely disagree about first principles. Nutrition, physical activity, sleep, stress, and behavioral patterns sit at the foundation of nearly every chronic disease conversation. We counsel patients on these topics every day, sometimes passionately, sometimes hurriedly, often within the narrow time constraints of a packed clinic schedule.

Yet an uncomfortable gap persists between what we know drives long-term outcomes and what we are realistically able to deliver in routine …

The art of medicine and clinical reasoning: a lesson at the bedside

Fazlur Rahman, MD

Physician

April 2, 2026

Throughout my years in medical training, I had heard the maxim, “Medicine is an art.” And yet this notion seemed abstract to me; after all, I had been steeped in science.

Then I came under the spell of a teacher, Professor S. M. Rab, the chairman of the Department of Medicine at DMC. It was he who finally showed me what the art of medicine was all about.

“Simply piling up scientific …

Reclaiming human dignity as the foundation of medical practice [PODCAST]

The Podcast by KevinMD

Podcast

April 1, 2026

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

Former Treasurer of the American College of Physicians Janet A. Jokela discusses the article “The service of humanity: Recommitting to physicians’ ethical duties.” Janet reflects on her visit to the Ronald Reagan …

The pediatric home health system is failing children with cancer

Alexis Chen Boulter, MD

Conditions

April 1, 2026

A little boy shuffles down the hallway in his yellow hospital-issued socks, completing yet another lap around the unit. You would never guess that he has leukemia, a blur of dark hair and restless energy. In many ways, he is the healthiest child on the pediatric oncology floor. Today marks his twentieth consecutive day in the hospital. Yet he does not have to be here to receive the drug he …

How your clinical notes impact military veterans’ disability benefits

Robin Hoon, RN

Conditions

April 1, 2026

Your patient stops showing up for follow-ups. They are rationing medications you prescribed. They cannot afford the specialist you referred them to.

You assume it is financial stress or insurance issues, but it could simply be due to what is missing from your chart notes, a pattern that is especially common among military veterans navigating disability benefits.

After more than 20 years in clinical practice serving patients with disabilities, including many military …

How prior authorization and step therapy harm pain management

Kayvan Haddadan, MD

Physician

April 1, 2026

Imagine a 54-year-old construction worker named Mike living with debilitating chronic lower back pain after years on the job. His doctor recommends a targeted epidural steroid injection and a short course of physical therapy combined with a non-opioid medication that has helped many patients in similar situations regain function and avoid surgery. But the insurance company says no. First, Mike must try cheaper generic pain pills that barely touch his …

Pajama time is for fools

Armand Rodriguez, MD

Physician

April 1, 2026

I really tried to have AI come up with an innocuous-sounding title for this piece: “Caring Hearts, Lighter Wallets: The Financial Reality of Primary Care.” But my poor judgment prevailed so I just decided to insult all of my colleagues right from the start. I assure you, for better or worse, that this article is my original opinion although with AI editing for grammar and clarity (but unfortunately not brevity). …

Read more…

Pajama time is for fools

Overcoming physician burnout with a new care model

Jerina Gani, MD, MPH

Physician

April 1, 2026

Many physicians do not talk about this openly, but at some point in their careers, a quiet question begins to surface: Is this really what it is supposed to feel like? After years, often decades, of training, sacrifice, and dedication, all of us as primary care physicians find ourselves in a position that, on paper, looks successful. We are caring for thousands of patients, maintaining full schedules, and carrying immense …

When the doctor is also the patient’s mom: Navigating severe autism

Joele Tueno Scott

Conditions

April 1, 2026

Today I received a call from my son’s school informing me that he had been suspended for injuring his teacher and hurting another staff member. The week prior, I had received multiple calls requesting that I pick him up early due to escalating behaviors.

My story is not unique. Across the country, parents of children with autism navigate aggressive outbursts, elopement, self-harm, and school suspensions. We juggle IEP meetings, medication adjustments, …

How ethical dilemmas in medicine affect body donation

Francisco M. Torres, MD

Physician

April 1, 2026

Many clinicians recall cases that stand out not for their diagnostic complexity, but for their ethical dilemmas. One such experience involved a long-time patient, a devout Catholic in his 70s, who asked if donating his body to science conflicted with his church’s teachings.

For years, I have displayed a favorite prayer on a poster in my office called “Prayer of the Catholic Physician.” This display gave my patient the opening to …

Why standardized medical exams filter for compliant workers

Robert Trent

Education

April 1, 2026

The American education system was not designed to produce scientists; it was designed to produce “interchangeable parts.” Frederick Gates, the architect of the Rockefeller-funded General Education Board, famously stated: “I do not want a nation of thinkers, I want a nation of workers.” While we like to imagine medical education has evolved, the reality is that our high-stakes testing, from the GRE to the USMLE, serves as a high-fidelity filter …

Finding purpose as an international medical graduate in the U.K.

Dr. Afsar Ashraf and Dr. Amal Pulikkal

Physician

April 1, 2026

The second time I landed in the U.K., the dream felt different. My first trip was for an exam; this time, it was for good. I walked into the arrivals hall with two bags. One was a worn suitcase packed with stethoscopes and textbooks. The other was invisible but far heavier, filled with my parents’ hopes and my wife’s unwavering faith.

In the bustling chaos of the international boarding area, after …

Why physicians must lead the design of artificial intelligence in health care [PODCAST]

The Podcast by KevinMD

Policy

March 31, 2026

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

Family physician, medical device inventor, and health care entrepreneur Tod Stillson discusses the article “AI governance in health care: Why physicians must lead the design.” Tod warns that the greatest threat to …

Global health security and WHO: Why U.S. withdrawal is dangerous

Adeel Khan, MD

Physician

March 31, 2026

In an increasingly globalized world, pathogens travel faster than ever before. Commercial aviation connects remote villages to major metropolitan hubs in less than a day. Supply chains stretch across continents. Climate change is expanding the geographic range of disease-carrying animals and insects. Against this backdrop, the decision by the United States to withdraw from the World Health Organization (WHO) is not merely short-sighted, it is strategically misguided and frankly dangerous.

Global …

Why women’s sleep struggles are often dismissed, misdiagnosed, or overshadowed

Kimberly L. Sterling, PharmD and Audrey Wells, MD

Conditions

March 31, 2026

Sleep is a commonly overlooked aspect of women’s health, yet its absence is quietly taking a toll on millions of lives. Caregiving responsibilities, hormonal shifts, and the relentless mental load of modern life leave women uniquely vulnerable to poor sleep. For many women, poor sleep and feeling tired is seen as normal or expected. Cultural and clinical stigmas often discourage women from seeking help, with many being told …

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