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Lifestyle, mindfulness, and the neuroscience of happiness

Physician

May 23, 2026

I have been gathering information about the neuroscience of happiness for over a year now, since the completion of my previous book, Legal Mind in Medicine, and decided to put a glimpse of it in an article form for the Memorial weekend reading.

Happiness stands as a central human pursuit, shaping our physical health, mental resilience, productivity, and relationships. As physicians, understanding the science of well-being offers real value. It …

When normal creatinine hides post-operative kidney injury

John Erbey, PhD

Conditions

May 23, 2026

The conversation in the surgical ICU happens the same way every time.

“His creatinine spiked post-op, but it came back down before discharge. The labs look normal now. The kidney recovered.”

Cardiac surgeons hear this reassurance so often it’s become standard. The patient leaves the hospital with normal kidney function on the discharge summary. By every conventional metric, the surgery was a success. The acute kidney injury was resolved.

Except it didn’t. Not …

The hidden cost of medical malpractice litigation

Gerald Kuo

Conditions

May 23, 2026

The emergency department was bright after midnight. An older man in his 80s arrived short of breath and frightened, surrounded by anxious family members. He had diabetes, chronic kidney disease, heart failure, and a recent fever. The nurse checked his blood pressure and tried to calm his daughter. The physician reviewed the chart and knew immediately: This would not be a simple night.

In medicine, we often work in the gray …

Why medical training ignores the business of medicine

Santoshi Billakota, MD

Physician

May 23, 2026

We spend a lot of time talking about how broken the medical system is: burnout, moral injury, administrative overload, loss of autonomy. We propose solutions: better workflows, more staffing, policy reform, technological innovation. But there is a harder truth we tend to avoid. The overall medical training system needs an overhaul.

Medical training does not just teach knowledge and clinical skill; it shapes identity, hierarchy, and thought patterns. From the earliest …

Fragmented care needs clinical direction, not more data

Alan P. Feren, MD

Physician

May 23, 2026

Patients often assume that someone is directing their care. That there is a clinician who sees the whole picture, integrates the information, and guides what happens next. In many cases, that is not how modern care is structured. Patients move between clinicians (primary care, specialists, urgent care, consultants), each focused appropriately on a specific aspect of the problem. Each encounter may be thorough. Each decision may be reasonable. Each plan …

How lifestyle interventions reverse type 2 diabetes

Mahima Gulati, MD

Conditions

May 23, 2026

I was a resident physician in New York City when I met a Jamaican woman in her early 40s, newly diagnosed with type 2 diabetes. The hospital was always crowded and the schedules unpredictable, making continuity difficult. But appointment after appointment, she found her way back to me. She trusted me and even brought me gifts on holidays.

Her hemoglobin A1c was 7.2. She had mild obesity, and no major complications. …

Why thymic involution is the aging organ doctors miss

Francisco M. Torres, MD

Conditions

May 23, 2026

There is an organ sitting behind my sternum that most of my patients have never heard of. Most of my colleagues rarely mention it. And yet, quietly, steadily, for the past four decades, it has been disappearing.

The thymus. The schoolhouse of the immune system. The place where T cells learn to distinguish self from non-self, friend from threat. By the time most of us reach our fifties, roughly 85 …

How HIV stigma creates barriers to effective HIV care

Alejandro Acety

Conditions

May 23, 2026

HIV in Puerto Rico is no longer defined by lack of treatment, but by the persistence of stigma. From my perspective as a Doctor of Nursing Practice (DNP) student and future Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), stigma remains one of the most significant barriers to effective HIV care. While biomedical advances such as antiretroviral therapy (ART), pre-exposure prophylaxis (PrEP), and the Undetectable = Untransmittable (U=U) framework have transformed HIV …

Primary care, bloodletting, and what medicine got right [PODCAST]

The Podcast by KevinMD

Podcast

May 22, 2026

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

Robert C. Smith is best known for arguing medicine lost its mind. This episode he explains why he is still proud to be a doctor. Primary care physicians deliver 75 percent of the …

Prescribing is down, opioid overdose deaths are not

Richard A. Lawhern, PhD

Conditions

May 22, 2026

It is often said in popular literature that figures lie and liars figure. However, sometimes in science, the lie is by omission. What we don’t say can be even more important in our conclusions than what we do. Two charts illustrate this principle in a centrally important issue of U.S. clinical practice.

The first chart is compiled by Statista, a well-respected data services company known worldwide. It addresses the relative potency …

Wearable technology saves lives through early detection

Sidney J. Winawer, MD

Conditions

May 22, 2026

I am a 94-year-old physician who would like to share a recent experience in which my Apple Watch played a critical role in the detection of a life-threatening event.

Over the course of my career, I focused on early detection and prevention in medicine, particularly in colorectal cancer. This made my recent personal experience with early detection of a cardiac event and prevention of its serious consequences through wearable technology especially …

Medicare will pay for the work your nurses already do

Rachel Yates, RN

Conditions

May 22, 2026

Walk into any independent primary care practice and ask the nurse what she did on her lunch break. There’s a good chance she’ll tell you she was on the phone with the daughter of a dementia patient, calling the dialysis center to sort out a transportation problem, or following up on the discharge med rec for the COPD patient who landed in the ED again last week. None of it …

How cross-sector collaboratives cut health care costs

Christine Schuster, RN, MBA

Policy

May 22, 2026

Health care costs continue to rise, yet the conversation about why often feels like a loop. Hospitals point to insurers. Insurers point to hospitals. Pharmacy benefit managers cite manufacturers. Manufacturers point back across the system. Meanwhile, patients are left trying to make sense of bills that feel disconnected from the care they received. In Massachusetts, often viewed as a national model for health care coverage, the average total cost of …

Diagnostic bias almost cost me my life

Victoria Rundus, MD

Conditions

May 22, 2026

F*ck fibromyalgia? No, f*ck diagnostic bias.

I’m in pain today, so please forgive the profanity. Pain has become a constant companion for me for several years now, though some days are worse than others.

I am also a pediatrician, which means I am one of the “nice doctors” who does not curse. I have never been particularly good at following that expectation outside of the exam room.

As I lay in a hospital …

Read more…

Diagnostic bias almost cost me my life

3 new pharma marketing tactics every physician should know

Martha Rosenberg

Meds

May 22, 2026

Weeks after a FiercePharma webinar told drug reps to make the lab worker their first sales point and not the patient’s doctor (to avoid a delay in “therapy adoption”), the three-day Fierce Pharma Engage conference in San Diego unveiled more aggressive, stealth sales tactics.

At the well-funded meet-and-greet with 700 well-turned-out attendees, 150 speakers, and 56 corporate sponsors, we learned that:

1. AI will take over interactions with doctors (HCPs)

Whether …

Why health care accountability demands system readiness

Tiffiny Black, DM, MPA, MBA

Policy

May 22, 2026

Most conversations about failure in health care begin in the same place: What went wrong? A patient safety event. A staffing collapse. A breakdown in communication. A system failure that appears, at first glance, to be sudden and unexpected. But what if the more important question is not what went wrong, but what was already known?

Health care does not suffer from a lack of awareness. The signals are there: rising …

Unlocking career flexibility with a Courage Fund

Stanley Liu, MD

Finance

May 22, 2026

Most of the time in my work as a financial planner, my job is to help fellow physicians think long-game so they can craft a sustainable career and life they love. Today is different. We are going to focus on the short game and introduce a financial concept I call the “Courage Fund.” If you are hoping to create a more flexible career, and you cannot wait years …

Why perimenopause insomnia hurts metabolic health

Isabella Soreca, MD

Conditions

May 22, 2026

Ask most physicians when perimenopause begins and they will point to the menstrual cycle: irregular periods, shortened cycles, the first hints of hormonal flux. Ask most women and they will say the same. We have built an entire cultural narrative around the period as the harbinger. But for a significant number of women, perimenopause announces itself first at 3 a.m. Not with a hot flash. Not with missed bleeding. With …

Social media told her to abort her Turner syndrome baby

Stephanie Waggel, MD

Conditions

May 22, 2026

Two of my recent teaching topics with medical students have been people taking medical advice from social media and the rise of “wild births,” where babies receive no medical care whatsoever. Then I opened one of my Facebook moms’ groups and saw a pregnant woman post that her baby’s genetic screening came back positive for Turner syndrome. Immediately, strangers in the comments started telling her to abort. Not physicians. Not …

Prior authorization delays vital transplant medication

Payton Herres

Conditions

May 22, 2026

I am a heart transplant recipient. I understand the responsibility that comes with the organ I was given. I take my medications exactly as prescribed. I go to my appointments. I monitor for anything that could signal a problem. I do everything I am supposed to do. And I still almost ran out of my transplant medication.

What I was not prepared for was having to fight to get the medication …