KevinMD.com

November 10, 2026Nov 10, 2026

In August 2025, I wrote a piece for KevinMD titled "Are we repeating the statin playbook with lipoprotein(a)?" I was skeptical of the excitement surrounding a new generation of drugs that could lower Lp(a) by 80 to 90 percent. Not…

In August 2025, I wrote a piece for KevinMD titled “Are we repeating the statin playbook with lipoprotein(a)?” I was skeptical of the excitement surrounding a new generation of drugs that could lower Lp(a) by 80 to 90 percent. Not because I knew they wouldn’t work, but because nobody had demonstrated that lowering Lp(a) actually prevented heart attacks.

I had seen this movie before with HDL cholesterol. We spent years …

Health technology

Clinical AI scored 38 and 83 percent on the same questions

Vinson James, MD

November 10, 2026Nov 10, 2026

When Brian Hudes, MD, wrote "Why prompt engineering for physicians fails at 2 a.m." on KevinMD in September, he opened with my research. I appreciated that. Then he disagreed with my conclusion. I appreciated that even more. Let me explain…

When Brian Hudes, MD, wrote “Why prompt engineering for physicians fails at 2 a.m.” on KevinMD in September, he opened with my research. I appreciated that. Then he disagreed with my conclusion. I appreciated that even more. Let me explain what I actually found, and why I think we’re both right, just about different parts of the same problem.

What my study showed

I tested six AI models (ChatGPT, Copilot, …

Conditions and diseases

Esketamine for depression often works better by month 3

Ravi Singareddy, MD

November 10, 2026Nov 10, 2026

The most common pitch for esketamine has been speed: a nasal spray that can ease treatment-resistant depression within days, not weeks. But a new systematic review and meta-analysis in the Journal of Affective Disorders suggests the more useful clinical lesson may be the opposite. When the authors pooled nine observational studies of intranasal esketamine used in routine practice, they found that patients were about five times more likely to be …

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Physician voices

Why doctors are miserable even after they make it

Lily Johnston, MD, MPH

November 10, 2026Nov 10, 2026

An excerpt from Disconnected: A Surgeon's Search for Healing in a Broken System. It's 2022, and at age thirty-eight, I have finally arrived at the summit. Seventeen years. That's how long it took to ascend this mountain: four years of…

An excerpt from Disconnected: A Surgeon’s Search for Healing in a Broken System.

It’s 2022, and at age thirty-eight, I have finally arrived at the summit. Seventeen years. That’s how long it took to ascend this mountain: four years of college, four years of medical school, seven years of surgical residency and research, and two more years of subspecialty fellowship in vascular surgery. Seventeen years, all leading to this moment. …

The Podcast by KevinMD

Changing careers in medicine? Ask yourself, not everyone else [PODCAST]

The Podcast by KevinMD

November 9, 2026Nov 9, 2026

Deciding on a career change can turn into polling everyone you know until someone says what you want to hear. Lauren Fine, an allergist-immunologist and founder of Permission to Change, felt that pull when she moved from mostly clinical work…

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Conditions and diseases

What personalized nutrition apps get wrong about glucose

Hana Kahleova, MD, PhD, MBA

November 9, 2026Nov 9, 2026

A patient without diabetes came in recently with her phone open to a chart. For three weeks, she had worn an over-the-counter glucose sensor and logged every meal in an app that promised a diet tuned to her biology. The app had flagged her morning oatmeal and her lentil soup as “spike foods,” so she had stopped eating both. Her labs were normal. What she wanted from me was permission …

Health policy

Strengthen primary care no matter who pays

Narinder Singh Parhar, MD

November 9, 2026Nov 9, 2026

American voters have brought health care affordability back to the center of our national conversation. Younger Americans, in particular, face a difficult question: Will the system they are helping finance be accessible, affordable, and sustainable when they need it? As…

As elected leaders prepare to assume their responsibilities, the medical profession has a responsibility of its own. We should bring forward practical proposals that can help turn public expectations into better care.

Coverage …

Physician voices

Interruptions in health care cost patients and trainees

Gus W. Krucke, MD

November 9, 2026Nov 9, 2026

Earlier in my career, I rounded with interns, residents, a chart rack, and a charge nurse. We disagreed and had competing demands, but working alongside one another gave us some sense of what was happening down the hallway. I knew when a nurse was doing something that could not wait. The nurses knew when I was examining a patient, teaching, or helping a family understand that someone was dying. We …

Conditions and diseases

Why trying too hard to sleep keeps you awake at night

Pedram Navab, DO

November 9, 2026Nov 9, 2026

An excerpt from The Alchemy of Sleep: The Science, Mystery, and Magic of a Good Night's Rest. As I tell my patients time and again, sleep is a paradoxical act. It requires us to do nothing, yet we often try…

An excerpt from The Alchemy of Sleep: The Science, Mystery, and Magic of a Good Night’s Rest.

As I tell my patients time and again, sleep is a paradoxical act. It requires us to do nothing, yet we often try too hard to make it happen. In our modern, productivity-driven world, this surrender (the act of simply letting go) feels unnatural. It feels passive. It feels weak. It feels selfish …

Physician voices

Why life as an attending feels like medical school again

Harold Kraft, MD

November 9, 2026Nov 9, 2026

When you are a medical student, you secretly believe a comforting myth: Once you pass your boards and survive training, you will finally stop running. Then you become an attending physician. And one morning, it hits you: You are still…

When you are a medical student, you secretly believe a comforting myth: Once you pass your boards and survive training, you will finally stop running.

Then you become an attending physician. And one morning, it hits you: You are still sprinting. You are wearing different clothes, but you are still gulping lukewarm coffee, and still staring at a glowing tablet.

The tragic comedy of that shared rat race is now a two-minute …

Health technology

Chatbots and bipolar disorder: a mania risk families miss

Nicole Drapeau Gillen

November 9, 2026Nov 9, 20262

Most of the conversation about AI chatbots and mental illness has focused on psychosis: delusions validated, paranoia reinforced, people convinced a chatbot is sentient or divine. That focus makes sense. But it has left a gap, and families living with…

The evidence that chatbots can harm people with serious mental illness is growing. When researchers at Aarhus University screened the health records of nearly …

Physician voices

Why independent physicians need a third option

VitalMD

November 9, 2026Nov 9, 2026

Physicians today face enormous challenges in order to remain independent and, for private-practice OB/GYNs, it's about to get harder. Come January 1, 2027, obstetrician-gynecologists across the country will see a significant restructuring of maternity care services codes. The specialists' longstanding…

Physicians today face enormous challenges in order to remain independent and, for private-practice OB/GYNs, it’s about to get harder. Come January 1, 2027, obstetrician-gynecologists across the country will see a significant restructuring of maternity care services codes. The specialists’ longstanding billing model will become more encounter-based, creating a greater number of individual billing events. This transition will offer more opportunities to appropriately capture the care OB/GYNs provide, but it …

Physician finance

Whole life insurance for high-income earners is no tax hack

Brian Hanks, MBA, CFP

November 9, 2026Nov 9, 2026

An excerpt from Taxes for Dentists: How Smart Dentists Lower Their Taxes. Whole life insurance might be the single most persistent tax pitch sold to dentists. You hear about it at conferences, during CE dinners, on LinkedIn, and from your…

An excerpt from Taxes for Dentists: How Smart Dentists Lower Their Taxes.

Whole life insurance might be the single most persistent tax pitch sold to dentists. You hear about it at conferences, during CE dinners, on LinkedIn, and from your cousin at Thanksgiving. The promise is always the same: It’s a secret strategy for smart, rich people, a can’t-miss investment, and it’s always tied to taxes.

And when you first hear …

The Podcast by KevinMD

Doctors can spot a failing patient. Can they spot a failing hospital? [PODCAST]

The Podcast by KevinMD

November 8, 2026Nov 8, 2026

When a hospital replaces an established physician team, the beds can stay open while the care behind them quietly erodes. Shelly Haug Monti is a neonatologist, palliative care physician, and bioethicist, and a cofounder of Babies First Southern Oregon. This…

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Physician voices

Expedition medicine needs evidence, not just summit photos

Michael Grinn, MD, MPH

November 8, 2026Nov 8, 20262

In cardiac anesthesia, a monitor gives me information. It does not make the decision for me. The number still needs a person who understands what is happening, what has changed, and what to do next. That distinction is central to…

In cardiac anesthesia, a monitor gives me information. It does not make the decision for me. The number still needs a person who understands what is happening, what has changed, and what to do next.

That distinction is central to how I think about expedition medicine. In January 2027, our ASCENT expedition through Pulse at the Peak is planned for Aconcagua, a mountain approaching 7,000 meters. The question I want to …

Conditions and diseases

I defended nicotine. Then I found my own heart disease.

Larry Kaskel, MD

November 8, 2026Nov 8, 2026

Last year, I wrote an article for KevinMD defending nicotine. My argument was straightforward: Nicotine had been unfairly demonized because of its association with cigarettes, and we'd largely ignored its potential therapeutic benefits. I still believe that. But a few…

Last year, I wrote an article for KevinMD defending nicotine. My argument was straightforward: Nicotine had been unfairly demonized because of its association with cigarettes, and we’d largely ignored its potential therapeutic benefits. I still believe that.

But a few weeks ago, I underwent a coronary CT angiogram and discovered that I have coronary artery disease. Suddenly, my interest in nicotine was no longer entirely academic.

I enjoy nicotine. Not cigarettes. …

Health policy

When the patient portal is the only way to reach your doctor

Arthur Lazarus, MD, MBA

November 8, 2026Nov 8, 2026

An excerpt from METACINE: Essays on Health Care in a Changing World. Primary care is meant to be medicine's front door: the familiar place where a patient can discuss a new symptom, a lingering worry, a medication question, or simply…

An excerpt from METACINE: Essays on Health Care in a Changing World.

Primary care is meant to be medicine’s front door: the familiar place where a patient can discuss a new symptom, a lingering worry, a medication question, or simply the uneasy sense that something is not right. It is meant to be a relationship, not merely a point of entry into a larger system.

Yet as hospital chains acquire more …

Drugs and prescribing

After an FDA recall, patients need a plan for the next dose

Danielle Lightsey, RPh

November 8, 2026Nov 8, 2026

A medication recall can answer an important question about a product while leaving the patient's next question unresolved: What should I do about my next dose? That gap matters. A headline may name a medicine without identifying the particular package…

A medication recall can answer an important question about a product while leaving the patient’s next question unresolved: What should I do about my next dose?

That gap matters. A headline may name a medicine without identifying the particular package in a person’s home. A notice may explain a manufacturing problem without explaining how an individual will obtain a replacement. Information about a defective product and advice about continuing treatment serve …

The Podcast by KevinMD

Alzheimer’s treatment works best early, so why are patients waiting? [PODCAST]

The Podcast by KevinMD

November 7, 2026Nov 7, 2026

Two Alzheimer's drugs now slow the disease, and they work best when symptoms are still mild. Emer MacSweeney is a neuroradiologist and the cofounder and CEO of Re:Cognition Health. This episode is based on her article "Early Alzheimer's detection is…

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Two Alzheimer’s drugs now slow the disease, and they work best when symptoms are still mild. Emer MacSweeney is a neuroradiologist and the cofounder and CEO of Re:Cognition Health. This episode is based on her article “Early Alzheimer’s detection is now a treatment decision,” published on KevinMD. She explains …

Health policy

Rebuilding public trust in science after COVID-19

Rao M. Uppu, PhD

November 7, 2026Nov 7, 2026

On March 19, 2020, I was called to a meeting by Dr. Bijoy Sahoo, who was serving as provost of our university at the time. I was serving as vice president of the Faculty Senate, and because the Senate president was unavailable, I attended the meeting on behalf of the faculty. The university faced an urgent challenge: how to protect students, faculty, and staff from a rapidly spreading pandemic while …

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