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What happens when a Division I athlete loses 40 pounds, can barely form sentences during practice, and keeps hearing from doctors that it might just be anxiety? Kamiah Gibson, a D1 women’s volleyball …
I ate plain rice and chicken for six months because no one explained celiac [PODCAST]
In every operational environment I have worked in, labor is visible. It is assigned, measured, and supported. Health care is the only sector where the system routinely generates work it does not staff, does not track, and does not claim. Instead, that work is absorbed by patients, clinicians, and caregivers who carry it because the alternative is delay or failure. This quiet transfer of labor is what I call the …
The silent burden in health care and administrative waste
An excerpt from Friendship Skills for Neurodivergent Adults: A Guide for the Anxious, Uniquely Wired, and Easily Distracted.
Your neurology, your experiences, your strengths, and your weaknesses affect how you see the world. Understanding your brain helps you understand your life, your mindset, and the science behind your behavior, so that is exactly where we will begin. By understanding your neurotype, you can better understand your brain and create neurodivergent-friendly …
Why neurodivergent friendship is challenging but possible
A school bell rings inside the Jen Chi station-front building, a historic health and social welfare hub in Taipei.
For a visitor, it may sound ordinary. For staff, it marks the end of another class, another session, another carefully planned activity for older adults. For family caregivers, it may mean a short moment of relief. For a person living with dementia, the sound may not become a lasting memory, but it …
Caring for the caregivers builds dementia-friendly cities
Most EHR demos are built around the same set of features: mobile access, AI-assisted documentation, integrated billing, patient portal design, and telehealth. Those features matter, but they do not prove the system will work in a real clinic day.
The demo is a controlled environment. The vendor chooses the patient, the encounter, the documentation path, the billing example, and the person clicking through the screen. A clean demonstration can hide a …
EHR vendor evaluation should happen before the demo
Physicians are trained to listen for symptoms that point to deeper problems. For example, chest pain can mean heart disease, and ongoing fatigue might signal depression or another illness. I once cared for a middle-aged teacher who showed how political divisiveness can affect health. She came in with headaches and trouble sleeping. While we spoke, she shared that her symptoms got worse during heated political debates at her school and …
How political divisiveness impacts your health and well-being
If you think one word inside a medical expert report cannot break a case, look at what happened in Kline v. Zimmer. A defense expert testified about possible alternative causes of a plaintiff’s injury, not probable ones. That single word, possibly, is the reason opinions like his are routinely challenged. Across multiple jurisdictions, courts have held that an expert who testifies in possibilities is offering no evidence at all.
In civil …
Medical expert witness report language gets cases struck
A recent report documented something remarkable: Americans on glucagon-like peptide-1 (GLP-1) agonists are falling in love with exercise for the first time. A man who struggled to walk to his mailbox now hikes seven miles a day. A woman who needed a cane ran her first five-kilometer (5K) race. A rock climber went from three workouts a week to five.
These drugs proved what physicians should have said more clearly long …
GLP-1 agonists and the hidden power of outdoor exercise
It started with a tiny scratch. A man tending his farm had pricked his finger on a thorn. He shrugged it off. Days later, he returned to the clinic with a fever, swelling, and excruciating pain in his arm. Within hours, the flesh on his hand and forearm was dying, a necrotizing infection, a flesh-eating bacteria taking hold. I have seen this story more times than I care to count …
How minor injuries lead to flesh-eating bacteria in rural Nigeria
Diagnostic radiology, as a physician-staffed specialty, will not exist in its current form within 20 years. Neither will diagnostic pathology. Neither, in all likelihood, will the outpatient model of endocrinology or general internal medicine as we currently understand it. These are not fringe predictions from technologists who have never set foot in a hospital; they are the logical endpoint of capability curves …
Why artificial intelligence displacement threatens medical specialties
Consider a pediatrician and his wife, a cardiologist. Together they earn over $700,000 per year. They have $200,000 sitting in a savings account earning 4 percent. They own a $750,000 house and lease a luxury sedan. They pay a financial advisor 1 percent annually to manage their retirement accounts, mostly because a colleague recommended him. Neither has ever heard of an expense ratio. When a friend suggests they open a …
Why your doctor invests like a vaccine skeptic
I have intubated people who took every pill they could find. I have told families, in bare conference rooms, that the person they brought in barely made it. I have done this across 23 years in emergency medicine, thousands of cases, in every configuration of crisis the human mind can produce, and I believed, the way physicians are trained to believe, that stabilizing the crisis was the job. That what …
The real work starts after a mental health crisis
At the American College of Cardiology meeting, a new trial was shared that might change how we view one of the world’s most common heart conditions. At its core, the study asked a simple but disruptive question: Do patients with atrial fibrillation really need to take blood thinners for the rest of their lives to prevent stroke? For decades, the answer has been yes. This trial suggests the answer …
Rethinking blood thinners for atrial fibrillation patients
When I was growing up in Darjeeling, a single pair of school shoes had to last the entire year. They came from Bata, simple, sturdy, and meant to endure more than they reasonably could. My sister, just a year younger than me, had the exact same pair. Side by side, our shoes began their journey identical, but they did not age the same way. She was careful, measured, and gentle …
How childhood scarcity fuels imposter syndrome in medicine
Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!
What happens when a physician searches her own name online and gets redirected to a billionaire-backed corporate clinic she has no connection to? Stephanie Waggel, a physician and …
I Googled my own name and a corporate clinic I’ve never worked at appeared [PODCAST]
It was a cold January night, around two in the morning on my third consecutive 34-hour shift as a senior pediatric resident at a major freestanding children’s hospital in the northeast. My floor had absorbed four admissions in the last hour, our eleventh of the night. The last was a teenage boy, new onset type 1 diabetes presenting in diabetic ketoacidosis. By the time the call came through from the …
Why artificial intelligence in medicine cannot replace clinical intuition
Pain medicine has expanded rapidly in both scope and technical complexity over the past two decades. At the same time, uncertainty surrounding fellowship recruitment, workforce stability, and long-term career sustainability has become more visible. While pain medicine is often described as an evolving interdisciplinary specialty, current trends suggest a broader structural question: whether the systems supporting training, research, and workforce development are evolving at the same pace as the therapies …
The evolving structural challenges of modern pain medicine
Shift change is one of the most critical windows in any hospital. It depends on teams staying tightly aligned across dozens of moving parts.
A respiratory therapist tweaks a ventilator seconds before a desaturation alarm triggers. Down the hall, a transporter clears a bottleneck to move a patient upstairs. At 3:00 a.m., a lab flags a subtle shift in bloodwork, changing the care plan before a crisis could unfold.
From the outside, …
National Hospital Week reveals what care really takes
Meet the standards. Demonstrate competence. Move forward. That is the promise medical students are told to trust.
But a federal lawsuit filed against a private medical school puts that promise to the test. What happens when academic standards, professionalism judgments, and disability accommodations collide?
At the center of that lawsuit is a fourth-year medical student who, according to public court filings, was dismissed amid allegations of disability discrimination, failure to accommodate, …
A medical school dismissal highlights disability discrimination
Artificial intelligence is no longer a distant concept in modern medicine. It is already entering clinical workflows through tools that draft patient notes, summarize charts, generate patient education materials, and assist with decision-making. At the center of this shift are large language models such as ChatGPT, Med-PaLM, and other health care-adapted systems. For clinicians, the most important question is not whether these tools are impressive. It is whether they understand …
The limits of large language models in clinical practice
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