KevinMD.com

October 2, 2026Oct 2, 2026

I can finally write this essay almost five years out. That's how long it took me to fully heal. To process. To gain perspective. I graduated residency in June 2020 at the height of COVID. I, along with my family,…

I can finally write this essay almost five years out. That’s how long it took me to fully heal. To process. To gain perspective.

I graduated residency in June 2020 at the height of COVID. I, along with my family, including my husband, two preschoolers, a four-month-old infant, and two dogs, drove from Miami to Chicago to complete an amazing fellowship. The year was perfect, though masked, sometimes scary, and full …

Medications

Does CVS controlled substance policy put patients at risk?

Arthur Lazarus, MD, MBA

October 2, 2026Oct 2, 2026

Recently, a close friend called me in a panic. He was running dangerously low on lorazepam and asked if I could prescribe a small, bridging quantity over the weekend until his regular refill was due in a few days. As a physician, I wanted to help, but I first advised him to do what any reasonable patient would: call his pharmacy, CVS, explain the situation, and ask for a sliver …

Health Policy

First Nations health care: Consultation is not control

Olumuyiwa Bamgbade, MD

October 2, 2026Oct 2, 2026

Canadian health organizations invite First Nations representatives to comment on services after budgets and priorities have already taken shape. Consultation can improve a proposal, but it offers limited influence when the decisions remain elsewhere. Health equity requires First Nations to…

For physicians, governance may seem distant from the examination room. Yet governance determines whether patients …

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Physician

Are antidepressant prescriptions for teens rising too fast?

Timothy Lesaca, MD

October 2, 2026Oct 2, 2026

She is fifteen and has been taking sertraline for three weeks. Her mother asks if we can increase the dose, since the first dose didn't work quickly enough. I look at her medication list, which is already longer than mine…

She is fifteen and has been taking sertraline for three weeks. Her mother asks if we can increase the dose, since the first dose didn’t work quickly enough. I look at her medication list, which is already longer than mine was at twice her age. I find myself doing something I rarely do during a seven-minute visit: I pause.

I do not doubt the value of antidepressants. I have seen these …

Physician

Who is liable for direct-to-consumer lab testing?

Joseph Phelan, MD

October 2, 2026Oct 2, 2026

Ever had a patient bring in a packet of test results you never ordered and countless questions on results for tests you've never even heard of? If not, prepare yourself. Direct-to-consumer (DTC) lab testing began modestly in 1977 when the…

Ever had a patient bring in a packet of test results you never ordered and countless questions on results for tests you’ve never even heard of? If not, prepare yourself.

Direct-to-consumer (DTC) lab testing began modestly in 1977 when the FDA approved at-home pregnancy tests. Over the last 50 years, it has evolved into a multi-billion-dollar industry offering hundreds of tests without a prescription. Some companies even sell panels of hundreds …

Physician Finance

Dennis Hursh, Esq, on physician employment contracts: a KevinMD subscriber spotlight

Subscriber Spotlight by KevinMD

October 2, 2026Oct 2, 2026

Dennis Hursh, Esq is a health law attorney with more than 40 years of experience and the founder of Physician Agreements Health Law, which reviews physician employment agreements for a fixed fee. He has published 27 essays on KevinMD since…

Conditions and Diseases

Medication for opioid addiction is the cornerstone of care

Walter S. Wightman, MD

October 2, 2026Oct 2, 2026

Addiction. The American Board of Preventive Medicine certified me as an addiction medicine specialist so how bad can the term be? My patients called themselves addicts. Heck, they called themselves junkies and fentanyl fiends. That’s not a license to stigmatize. Nor does it mean that substance use disorder patients appreciate people outside the clan calling them that. Just treat people with respect. The affliction truly is a disease, not a …

Health Policy

How an AI tool explained Ruan v. United States to doctors

Richard A. Lawhern, PhD

October 2, 2026Oct 2, 2026

As a health care educator with three decades of experience in research and hundreds of published papers, I have written at some length both on KevinMD and in clinical journals, concerning the dangers of artificial intelligence in medicine. I have also recently written about the profound differences between meanings of the term “Red Flag” in legal versus clinical contexts. Moreover, I have declared that predictive algorithms on …

Physician

An expert witness got patient autonomy exactly wrong

Howard Smith, MD

October 2, 2026Oct 2, 2026

One medical expert for the plaintiff attorney is most credited for the outcome in a widely publicized obstetric malpractice case against an academic medical center. That outcome is, at most, dubious, and that medical expert is, at most, highly credentialed, holding a medical degree along with several additional advanced degrees and training as an obstetrician and as a perinatologist.

It is his opinion that the baby suffered brain damage largely because …

Health Technology

AI psychosis warning signs families should watch for

Nicole Drapeau Gillen

October 1, 2026Oct 1, 2026

In a recent interview with UCSF Magazine, Dr. Karthik Sarma makes a careful point about the phrase "AI psychosis." It implies chatbots cause psychosis directly, and he doesn't think the evidence supports that. He prefers "AI-associated psychosis." Heavy chatbot use,…

In a recent interview with UCSF Magazine, Dr. Karthik Sarma makes a careful point about the phrase “AI psychosis.” It implies chatbots cause psychosis directly, and he doesn’t think the evidence supports that. He prefers “AI-associated psychosis.” Heavy chatbot use, he suggests, may be a symptom of an emerging episode rather than its cause. He also says it’s unlikely that someone with no risk factors or underlying vulnerability to …

Conditions and Diseases

Why health messages fail to change patient behavior

M. Bennet Broner, PhD

October 1, 2026Oct 1, 2026

In a recent poll, people indicated interest in maintaining brain health but expressed ignorance on how to do so. In a second poll, most men believed the herpes vaccine was only for young women, while in a third poll, only about 50 percent of women were aware of the importance of breast cancer screening. Other polls on health care information knowledge have shown similarly large awareness gaps. Given the substantial …

Physician

How therapeutic presence helps patients feel felt

Daniel J. Siegel, MD

October 1, 2026Oct 1, 2026

An excerpt from The Mindful Therapist: An Interpersonal Neurobiology Approach to Healing and Wholeness, second edition. Resonance is the coupling of two autonomous processes into a functional whole without losing the essence of each one. When we resonate with another…

An excerpt from The Mindful Therapist: An Interpersonal Neurobiology Approach to Healing and Wholeness, second edition.

Resonance is the coupling of two autonomous processes into a functional whole without losing the essence of each one. When we resonate with another person, we are changed by them but do not lose our essence in the joining. Resonance is not the same as mirroring or imitating. Resonance enables two differentiated elements of …

Physician

What to tell your anesthesiologist, even if it feels small

Dr. Girishkumar Modi

October 1, 2026Oct 1, 2026

Before surgery, anesthesiologists ask many questions. What medicines are you taking? Do you have any allergies? Have you had anesthesia before? Do you smoke or drink alcohol? Do you take any supplements? Do you snore heavily or use a CPAP…

Some patients answer comfortably. Others hesitate. That is understandable. A few questions may feel personal, and sometimes patients worry that the doctor may judge them. They may also think that …

Physician

Physician mentorship helps doctors endure the system

Britta Denman, DO

October 1, 2026Oct 1, 2026

I love being a doctor. I do not enjoy many aspects of practicing medicine in the U.S. health care system. In the struggle to balance these truths, mentorship from several extraordinary physicians has steadied me. As gifted diagnosticians and models…

I return to these mentors’ words often. Their guidance provides a framework I use to …

Health Policy

Climate anxiety in young people demands action in 2026

Gauri Gurumurthy, Preston Dang, and Rohini Kambhampati

October 1, 2026Oct 1, 2026

As medical students who will inherit and treat the health consequences of climate change, we are witnessing how it reshapes the physical and emotional landscapes of our generation. These fears are actively shaping how an entire generation plans its future, from whether to have children to where to live and work. Across the country, young people are experiencing what researchers have termed eco-anxiety: chronic stress, fear for the …

Patient

Why patient-owned health records beat a portal login

Jessica Chalk

October 1, 2026Oct 1, 2026

On KevinMD, patient advocate Monica McEathron wrote about a note in her medical record that labeled her insulin pump a "primary weapon." Her endocrinology team later documented that the insulin correction was appropriate and that the dangerous low came from…

On KevinMD, patient advocate Monica McEathron wrote about a note in her medical record that labeled her insulin pump a “primary weapon.” Her endocrinology team later documented that the insulin correction was appropriate and that the dangerous low came from a device communication failure. The note stayed in her chart anyway, waiting for the next emergency clinician to read it before reading anything else.

I read her piece twice. Then …

Physician

Blame culture in medicine leaves young doctors traumatized

Farid Sabet-Sharghi, MD

October 1, 2026Oct 1, 2026

It plays out like a modern-day digital horror movie. On my social media feed, a snippet of a horribly sad drama catches my eye: A young woman, devastated and paralyzed by an unimaginable tragedy, has taken the lives of her own children. She had previously been under medical care, presenting with a complex psychiatric history that navigated the difficult waters often met with multiple therapies: antidepressants, anti-anxiety agents, and various …

Health Technology

Will AI replace doctors? That is the wrong question.

Brandy Zachary, DC

October 1, 2026Oct 1, 2026

For most of my life, I have experienced medicine from both sides of the exam table. As a patient, I spent years on Social Security disability and accumulated diagnoses across specialties. At one point, I had my brain electrocuted twenty times for what ultimately turned out to be an infection. Eventually, a primary immunodeficiency helped explain why so many unrelated things had happened to me.

I went on to train more …

Physician

Direct-to-consumer drug ads sell lifestyle, not physiology

Ronald L. Lindsay, MD

October 1, 2026Oct 1, 2026

Direct-to-consumer drug advertising has changed dramatically over the past decade. What began as cautious messaging about serious medications has evolved into lifestyle marketing: smiling actors, golden retrievers, and promises of freedom, energy, and "getting back to what matters." The problem…

The problem is simple. Many of these drugs are not lifestyle enhancers. They are immune-altering, metabolic-altering, or infection-risk-altering agents. And the public is not hearing the truth.

As a developmental-behavioral pediatrician, I spent decades …

Health Policy

First Nations mental health care must not end at discharge

Olumuyiwa Bamgbade, MD

October 1, 2026Oct 1, 2026

An emergency department can stabilize a mental health crisis. It cannot, by itself, provide the relationships, housing, and continuing support that sustain recovery. For First Nations patients in Canada, we should promote mental health and substance use services that communities help govern, and patients can reach before, during, and after a crisis. For example, a patient receives instructions to arrange counseling, attend substance misuse therapy, and return if symptoms worsen. …

Real physician voices, twice a week

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