KevinMD.com: Social media’s leading physician voice

The KevinMD newsletterReal physician voices, twice a weekFree, and one click to unsubscribe.
Subscribe free →

Physician Finance

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

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…

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

…

Read more…

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

Conditions and Diseases

Medication for opioid addiction is the cornerstone of care

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.…

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 …

Read more…

Medication for opioid addiction is the cornerstone of care

Health Policy

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

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…

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 …

Read more…

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

Real physician voices, twice a week

Free, and one click to unsubscribe.

No spam. We never share your email.

Physician

An expert witness got patient autonomy exactly wrong

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,…

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 …

Read more…

An expert witness got patient autonomy exactly wrong

Health Technology

AI psychosis warning signs families should watch for

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 …

Read more…

AI psychosis warning signs families should watch for

Conditions and Diseases

Why health messages fail to change patient behavior

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…

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 …

Read more…

Why health messages fail to change patient behavior

Physician

How therapeutic presence helps patients feel felt

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 …

Read more…

How therapeutic presence helps patients feel felt

Physician

What to tell your anesthesiologist, even if it feels small

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…

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 machine?

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 …

Read more…

What to tell your anesthesiologist, even if it feels small

Physician

Physician mentorship helps doctors endure the system

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 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 of bedside medicine, they have meant as much to me personally as the knowledge they shared.

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

Read more…

Physician mentorship helps doctors endure the system

Health Policy

Climate anxiety in young people demands action in 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,…

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 …

Read more…

Climate anxiety in young people demands action in 2026

Patient

Why patient-owned health records beat a portal login

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 …

Read more…

Why patient-owned health records beat a portal login

Physician

Blame culture in medicine leaves young doctors traumatized

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…

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 …

Read more…

Blame culture in medicine leaves young doctors traumatized

Health Technology

Will AI replace doctors? That is the wrong question.

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…

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 …

Read more…

Will AI replace doctors? That is the wrong question.

Physician

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

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…

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 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 …

Read more…

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

Health Policy

First Nations mental health care must not end at discharge

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…

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. …

Read more…

First Nations mental health care must not end at discharge

Podcast

Diagnosing the data: Applying clinical rigor to AI adoption [PODCAST]

This episode is brought to you by ModMed. Fear of AI is not the problem. Refusing to test it is. Eric Jennings, a board-certified, fellowship-trained ophthalmologist and the senior medical director of ophthalmology at ModMed, argues that hesitancy about AI…

Listen on Apple Podcasts · Spotify

Youtube video

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

This episode is brought to you by ModMed.

Fear of AI is not the problem. Refusing to test it is. Eric Jennings, a board-certified, fellowship-trained ophthalmologist and the senior medical director of ophthalmology at ModMed, argues that hesitancy about AI is a protective clinical instinct, and that the right response …

Read more…

Diagnosing the data: Applying clinical rigor to AI adoption [PODCAST]

Podcast

Why more medicine isn’t making us healthier [PODCAST]

America spends nearly a fifth of its economy on health care, yet chronic disease keeps rising and prevention lags. Narinder Singh Parhar, an internist and intensivist with four decades of experience across outpatient, hospital, and ICU care, argues that American…

Listen on Apple Podcasts · Spotify

Youtube video

Listen and followApple PodcastsSpotifyYouTubeMore apps · Browse all episodes

America spends nearly a fifth of its economy on health care, yet chronic disease keeps rising and prevention lags. Narinder Singh Parhar, an internist and intensivist with four decades of experience across outpatient, hospital, and ICU care, argues that American medicine has grown top-heavy, brilliant at acute rescue but …

Read more…

Why more medicine isn’t making us healthier [PODCAST]

Medical Education

Clinical experience for pre-meds shapes career choices

An excerpt from The Premed Paradox. As I had seen my senior residents do in the past, and without a second thought, I picked up the sterile gauze, folded it over to create a padded protection from the glass of…

An excerpt from The Premed Paradox.

As I had seen my senior residents do in the past, and without a second thought, I picked up the sterile gauze, folded it over to create a padded protection from the glass of the lidocaine vial, and snapped off the top as required. To my absolute shock, I immediately felt the glass tip of the vial penetrate both gauze padding and sterile glove, …

Read more…

Clinical experience for pre-meds shapes career choices

Medical Education

Lessons from a pediatrician in conversation with her son

Intro My son is presently in his second year of internal medicine residency. When he was about to enter medical school, my older son thought it might be interesting for this "about to become a doctor" and his mother, "a…

Intro

My son is presently in his second year of internal medicine residency. When he was about to enter medical school, my older son thought it might be interesting for this “about to become a doctor” and his mother, “a long-time doctor,” to have a conversation about the journey. I realize now after transcribing and editing our conversations that this was much more than my life as a pediatrician; it was …

Read more…

Lessons from a pediatrician in conversation with her son

Health Technology

The patient’s story has no place in the electronic record

About 80 percent of a diagnosis comes from the patient's story. The electronic health record has no place to keep it. I learned the first half of that in my second year of medical school, in a physical diagnosis lecture…

About 80 percent of a diagnosis comes from the patient’s story. The electronic health record has no place to keep it.

I learned the first half of that in my second year of medical school, in a physical diagnosis lecture by the late Dr. Arthur Aufses Jr., chairman of surgery at Mount Sinai for 22 years and a man of extraordinary skill and intellect. In that lecture, he said that about …

Read more…

The patient’s story has no place in the electronic record

1567
pages