Addiction is no longer a clinical category. It has become the cultural baseline.
We used to think of addiction as something that happened to a few vulnerable people who “couldn’t handle” life’s pressures. Now it’s woven into everyday existence. Most of us reach for our phones before we reach for a breath. We chase stimulation without noticing we’re chasing. We live in a world that subtly trains us to crave.
Somewhere along …
Over the past decade, there has been a marked rise in adolescents and adults seeking autism evaluations. Many of these individuals are intellectually intact, verbally fluent, and professionally capable, yet have lived for decades with persistent social fatigue, sensory sensitivities, difficulty interpreting unspoken social rules, emotional overwhelm, rigid or all-or-nothing thinking, challenges with transitions, and extensive masking or camouflaging behaviors, all without a diagnosis. When they finally seek clarity, the …
Every New Year arrives with its familiar rituals. We raise a glass, make a resolution, and offer a toast to things we hope will be different this time around: better habits, better balance, better health. We say “I’ll drink to that” as shorthand for optimism, an easy affirmation that the future is still negotiable and a longer life is possible.
Then along comes a map.
We are hearing stories about mushrooms and MDMA and see clinics advertise ketamine. We hear of friends chasing a spiritual reset. Many in America feel the weight of depression, trauma, and addiction inside families. Psychedelics sit at the center of this pressure, with hope on one side and hype on the other.
KevinMD already published multiple essays on psychedelic medicine since 2022, including pieces on what physicians need to know, prudence …
“The ordinary response to atrocities is to banish them from consciousness. Certain violations of the social compact are too terrible to utter out loud: this is the meaning of the word unspeakable. Trauma survivors want to forget, observers want to forget, and society as a whole wants to forget. It is too painful to do otherwise. We push trauma away and it rears up in other ways: Atrocities, however, …
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Board-certified pediatrician and certified coach Jessie Mahoney discusses her article “The burden of the eldest daughter.” Jessie explores the unique psychological weight carried by firstborn women who are taught early on to …
Wellness programming must evolve beyond institutions if we are serious about supporting physicians, especially women physicians.
For wellness to be taken seriously, it had to begin within institutions. Those efforts offered visibility and legitimacy. But institutional wellness is not the whole answer.
For 17 years, I led wellness initiatives inside a large medical organization. I saw the value of bringing attention to physician well-being. I also saw the limitations. Six years ago, …
For the past several decades, Western spiritual culture has been profoundly shaped by the rebranding of Buddhist contemplative practices (mindfulness, presence, and the exaltation of “the now”). As a psychiatrist, I have witnessed the arrival of this movement inside the consultation room. Patients arrive quoting teachers, apps, and books urging them to stay present, to watch their breath, to release attachment to the future or past. Many have tried, often …
America’s physician shortage is no longer a distant projection. It is happening now, steadily, one resignation, early retirement, and practice closure at a time.
A nationwide, longitudinal analysis published in Annals of Internal Medicine tracked more than 712,000 physicians caring for Medicare patients over a decade and found a troubling trend: Physician attrition from clinical practice rose from 3.5 percent in 2013 to 4.9 percent in 2019, across every specialty, …
A recent Johns Hopkins study has reignited that debate. The research documents rapid growth in concierge and direct primary care practices and warns that these models may worsen access to care.
That framing feels intuitive. It is also incomplete.
It assumes that traditional primary care access was functioning before physicians began moving into fee-based models. It was not.
Long before concierge and direct primary care gained traction, primary care access had already …
As a physician-psychiatrist, I have watched the rise of GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound) with genuine admiration. They are transforming metabolic health, reducing cardiovascular risk, and offering hope to patients who have struggled for decades. For many, these medications are lifesaving.
But alongside the excitement, I’m witnessing something rarely discussed: a change in personality and affect, especially at higher doses.
This pattern reminds me of the early days of SSRIs. When …
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CEO, president, and founder of the Clinician Burnout Foundation Jodie Green and physician advocate and physical therapist Kim Downey discuss their article “Why wellness programs fail health care.” Jodie and Kim explain …
I direct a Faculty Well-being Champions Program overseeing 47 physician champions across 33 departments. I also practice palliative care part-time and coach physicians navigating burnout. I liaise with well-being leaders nationwide, some at programs just checking a wellness box, others genuinely trying to get it right. This year taught me that well-being work reveals patterns. The same destructive habits show up across institutions, specialties, and conversations.
As 2025 closes, here are …
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Palliative care physician and certified physician development coach Christie Mulholland discusses her article, “Reclaiming physician agency in a broken system.” She shares her personal story of leaving a prestigious academic position after …
I retired from my pediatric cardiology practice almost two years ago, and I keep circling back to one of the final days of my career. For a long time, I told myself I had simply burned out, worn thin by the pace and the paperwork. Only with time and reflection have I realized I didn’t step away because I was tired, I stepped away because of deep moral injury.
I remember …
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Psychiatrist Farid Sabet-Sharghi discusses his article, “The psychological trauma of polarization.” Farid explains how the human psyche is evolutionarily wired for connection, making the current climate of hostility and division deeply traumatic. …
Walk into a convenience store. You will see sleek bottles, gummies, shots, and powders in bright wrappers. Companies market them as calm, focus, energy, sleep, pain relief. People treat them like upgraded vitamins. They swipe a card and head home. Nobody runs a checklist on dose, interactions, tolerance, withdrawal, or contamination.
This culture runs on a simple story. Natural means safe and plant means gentle. Legal means regulated while a label …
“The meds made me do it” has become a familiar refrain whenever psychiatric treatment intersects with tragedy. It is a phrase heavy with implication, suggesting loss of control, a sense of medical betrayal, and a system that failed at its most basic task: keeping people safe. When cases like the Nick Reiner tragedy enter the public consciousness, that phrase resurfaces almost reflexively, offering a deceptively simple explanation for something incredibly …
The frequency and severity of physician burnout have resulted in an epidemic that is impairing the American health care delivery system. Herbert Freudenberger coined the term burnout in 1977, referring to a syndrome characterized by emotional exhaustion, depersonalization or cynicism, and a lack of personal accomplishment. He noted that burnout reduced health care workers’ ability to provide excellent patient care and adversely affected their well-being.
Physician burnout is rampant in the …
Adapted from Searching for Normal: A New Approach to Understanding Mental Health, Distress and Neurodiversity. (Penguin Random House Canada/Signal, 2025.)
February 1992. I’m in the consulting-room side of a one-way mirror divide. Opposite us in the room are four people: thirteen-year-old Sofia, her older sister Julieta, and their mother and father. The parents speak with a strong Spanish accent. The girls’ mother has an anxious look on her face. She …
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